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).
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.
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.
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.
Keywords: Behavioral science, Decision-making, Effectiveness, Health services research and Tobacco
See more of: Behavioral, Epidemiologic, and Health Services Research