{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,12]],"date-time":"2025-06-12T00:11:18Z","timestamp":1749687078005,"version":"3.28.0"},"reference-count":24,"publisher":"Georg Thieme Verlag KG","issue":"05","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Appl Clin Inform"],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background\u2003Tobacco use is a significant cause of morbidity and mortality in the United States. Even brief advice from a clinician can significantly influence cessation rates among tobacco users, but clinicians often miss opportunities to provide this simple intervention.<\/jats:p><jats:p>\n          Objectives\u2003The intent of this quality improvement project was to increase tobacco cessation among tobacco users by nudging clinicians using a clinical decision support (CDS) tool.<\/jats:p><jats:p>\n          Methods\u2003We developed a CDS tool using principles of user-centered design and the CDS Five Rights to dynamically insert actionable information about current tobacco users into the Assessment and Plan section of clinicians' notes. We conducted a retrospective analysis of patients at four primary care practices in the Denver Metro area evaluating the impact of the CDS tool on time to tobacco cessation. A multivariable Cox proportional-hazards model was used in this determination. Kaplan\u2013Meier curves were used to estimate tobacco cessation probabilities at 90, 180, and 365 days.<\/jats:p><jats:p>\n          Results\u2003We analyzed 5,644 patients with a median age of 45 years, most of whom lived in an urban location (99.5%) and the majority of whom were males (60%). The median follow-up time for patients was 16 months. After adjustment for age, gender, practice site, and patient location (rural, urban), the intervention group had significantly greater risk of tobacco cessation compared to those in the control group (hazard ratio: 1.22, 95% confidence interval: 1.08\u20131.36; p\u2009=\u20090.001).<\/jats:p><jats:p>\n          Conclusion\u2003This study suggests a CDS intervention which respects the CDS Five Rights and incorporates user-centered design can affect tobacco use rates. Future work should expand the target population of this CDS tool and continue a user-centered, iterative design process.<\/jats:p>","DOI":"10.1055\/a-1961-9800","type":"journal-article","created":{"date-parts":[[2022,10,17]],"date-time":"2022-10-17T23:17:13Z","timestamp":1666048633000},"page":"1116-1122","source":"Crossref","is-referenced-by-count":4,"title":["Improving Tobacco Cessation Rates Using Inline Clinical Decision Support"],"prefix":"10.1055","volume":"13","author":[{"given":"Lauren A.","family":"Drake","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine, Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Krithika","family":"Suresh","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Informatics, University of Colorado School of Public Health, Aurora, Colorado, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hillary","family":"Chrastil","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine, Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carmen L.","family":"Lewis","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine, Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard L.","family":"Altman","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine, Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2022,11,23]]},"reference":[{"volume-title":"The Health Consequences of Smoking\u201450 Years of Progress: A Report of the Surgeon General","year":"2014","author":"National Center for Chronic Disease Prevention and Health Promotion Office on Smoking and Health","key":"ref1"},{"volume-title":"A Report of the Surgeon General","year":"2020","author":"U.S. Department of Health and Human Services","key":"ref2"},{"volume-title":"Tobacco Control: Reversal of Risk After Quitting Smoking","year":"2007","author":"International Agency for Research on Cancer","key":"ref3"},{"issue":"05","key":"ref5","first-page":"CD000165","article-title":"Physician advice for smoking cessation","volume":"2013","author":"L F Stead","year":"2013","journal-title":"Cochrane Database Syst Rev"},{"issue":"40","key":"ref6","doi-asserted-by":"crossref","first-page":"1129","DOI":"10.15585\/mmwr.mm6440a1","article-title":"Trends in quit attempts among adult cigarette smokers - United States, 2001-2013","volume":"64","author":"S R Lavinghouze","year":"2015","journal-title":"MMWR Morb Mortal Wkly Rep"},{"issue":"06","key":"ref7","doi-asserted-by":"crossref","first-page":"472","DOI":"10.1016\/j.ypmed.2006.07.009","article-title":"Are physicians asking about tobacco use and assisting with cessation? 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