Preventing Chronic Disease | Patient Perspectives on Tobacco Use Treatment in Primary Care - CDC
Patient Perspectives on Tobacco Use Treatment in Primary Care
Jacqueline R. Halladay, MD, MPH; Maihan Vu, DrPH, MPH; Carol Ripley-Moffitt, MDiv, CTTS; Sachin K. Gupta, MD; Christine O’Meara, MD; Adam O. Goldstein, MD, MPH
Suggested citation for this article: Halladay JR, Vu M, Ripley-Moffitt C, Gupta SK, O’Meara C, Goldstein AO. Patient Perspectives on Tobacco Use Treatment in Primary Care. Prev Chronic Dis 2015;12:140408. DOI: http://dx.doi.org/10.5888/pcd12.140408
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Abstract
Introduction
Evidence-based tobacco cessation interventions increase quit rates, yet most smokers do not use them. Every primary care visit offers the potential to discuss such options, but communication can be tricky for patients and provider alike. We explored smokers’ personal interactions with health care providers to better understand what it is like to be a smoker in an increasingly smoke-free era and the resources needed to support quit attempts and to better define important patient-centered outcomes.
Evidence-based tobacco cessation interventions increase quit rates, yet most smokers do not use them. Every primary care visit offers the potential to discuss such options, but communication can be tricky for patients and provider alike. We explored smokers’ personal interactions with health care providers to better understand what it is like to be a smoker in an increasingly smoke-free era and the resources needed to support quit attempts and to better define important patient-centered outcomes.
Methods
Three 90-minute focus groups, involving 33 patients from 3 primary care clinics, were conducted. Participants were current or recent (having quit within 6 months) smokers. Topics included tobacco use, quit attempts, and interactions with providers, followed by more pointed questions exploring actions patients want from providers and outcome measures that would be meaningful to patients.
Three 90-minute focus groups, involving 33 patients from 3 primary care clinics, were conducted. Participants were current or recent (having quit within 6 months) smokers. Topics included tobacco use, quit attempts, and interactions with providers, followed by more pointed questions exploring actions patients want from providers and outcome measures that would be meaningful to patients.
Results
Four themes were identified through inductive coding techniques: 1) the experience of being a tobacco user (inconvenience, shame, isolation, risks, and benefits), 2) the medical encounter (expectations of providers, trust and respect, and positive, targeted messaging), 3) high-value actions (consistent dialogue, the addiction model, point-of-care nicotine patches, educational materials, carbon monoxide monitoring, and infrastructure), and 4) patient-centered outcomes.
Four themes were identified through inductive coding techniques: 1) the experience of being a tobacco user (inconvenience, shame, isolation, risks, and benefits), 2) the medical encounter (expectations of providers, trust and respect, and positive, targeted messaging), 3) high-value actions (consistent dialogue, the addiction model, point-of-care nicotine patches, educational materials, carbon monoxide monitoring, and infrastructure), and 4) patient-centered outcomes.
Conclusion
Engaged patient-centered smoking cessation counseling requires seeking the patient voice early in the process. Participants desired honest, consistent, and pro-active discussions and actions. Participants also suggested creative patient-centered outcome measures to consider in future research.
Engaged patient-centered smoking cessation counseling requires seeking the patient voice early in the process. Participants desired honest, consistent, and pro-active discussions and actions. Participants also suggested creative patient-centered outcome measures to consider in future research.
Acknowledgments
This work was supported by Health-e-NC, an initiative of the University Cancer Research Fund at the University of North Carolina at Chapel Hill. We are indebted to Cynthia Port, PhD, for her steadfast assistance with this manuscript and the Health-e-NC initiative of the University Cancer Research Fund at the University of North Carolina for its financial support.
Author Information
Corresponding Author: Jacqueline R. Halladay, MD, MPH, University of North Carolina at Chapel Hill, Department of Family Medicine, 590 Manning Dr, Chapel Hill, NC 27599. Telephone: 919-843-6607. E-mail: jacqueline_halladay@med.unc.edu.
Author Affiliations: Maihan Vu, Carol Ripley-Moffitt, Adam O. Goldstein, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Sachin K. Gupta, Christine O’Meara, Community-Based Family Practice Physicians, Cary, North Carolina. Dr Halladay is also affiliated with the Cecil G. Sheps Center for Health Services Research, Chapel Hill, North Carolina.
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