Dental Providers Use a Computer-Assisted Tool to Support Tobacco interventions

Objectives:

Tobacco use is a significant risk factor for periodontal disease and oral cancer. However, previous research suggests that delivery of evidence-based tobacco cessation by dental providers is suboptimal.

 The purpose of this study was to create a tobacco cessation decision support tool within the health history of the electronic dental record (EDR).

Methods:

The tobacco section of the health history was modified to contain items designed to measure 1) dependency; 2) interest in quitting and 3) quit attempts. This information was then used to develop a series of scripts to assist the dental provider supporting tobacco cessation. Script usage was recorded by the provider. The results presented are drawn from tool use in 7 intervention clinics.

Results:

Of the 385 tobacco-using patients who had encounters during the study period, 276 (72%) had one or more scripts marked as used. The modal number of scripts used was 2 with a value of 48% of encounters. Across all the encounters there were 815 scripts used. Of the clinics, script usage went from a low of 34% to a high of 96% (p<0.0001). There was no difference in usage by gender (70% Males; 72% females; p=0.761). There was a clear decline in usage by age with 18 to 29 year olds having scripts used 80% of the time verses 60 to 69 year olds using scripts 66% of the time (p=0.0053). There was no variation in script usage relative to daily cigarette usage, dependency level, previous quit attempts or interest in quitting.

Conclusions:

The evidence from this study suggests a computer-assisted tool, incorporated within the electronic dental record, if carefully developed, with the needs of the providers considered, will be used.