support for systems conducting tobacco cessation work gillian schauer, program manager, tcrc

Support for Systems Conducting Tobacco Cessation Work

Gillian Schauer, Program Manager, TCRC

Produced by the Tobacco Cessation Resource Center.

2

Agenda

• Introduction

• Why Tobacco Cessation?

• What is TCRC?

• Resources and Tools

• Upcoming Events

• Q & A and Discussion


3

Why Don’t They Just Quit?

Chain of Addiction:

• Biologically Addictive

• Psychologically Addictive

• Culturally Addictive


4

The Opportunity

• Most tobacco users want to quit.

• Half make a serious attempt each year.

• 80% see a healthcare provider each year.


5

Benefits

Benefits of a focus on tobacco cessation?

• Patient Satisfaction 1

• Improved Outcomes

• Cost Effective 2, 3

• Reimbursable 1 Solberg, LI et al.Patient Satisfaction and Discussion of Smoking Cessation

During Clinical Visits. Mayo Clin Proc. 2001;76:138-143.

2 Cummings SR, Rubin SM, Oster G. The costeffectiveness of counseling smokers to quit.JAMA 1989;261:75–79.

3 Tsevat J. Impact and cost-effectiveness of smoking interventions. American Journal of Medicine 1992;93:43S–47S.


6

The Tobacco Cessation Resource Center (TCRC)

Mission Statement: • TCRC exists to provide

training, mentoring, and resources to Health Care Providers, Health Delivery Systems, and those who work with Health Care Providers.

Objective: • To increase the number of

Health Care Providers who effectively intervene with their patients who use tobacco.


7www.tobaccoprc.org/TCRC/

http://www.tobaccoprc.org/TCRC/


8

5As Brief Intervention

ASK about tobacco use.

ARRANGE for follow-up.

ASSIST the patient in quitting.

ASSESS readiness to quit.

ADVISE the patient to quit.

The 5A Intervention


9

2A and R Brief Intervention

ASK about tobacco use.

ASSESS ASSIST

ARRANGE

REFER to resources

internal or external

entity that completes

the rest of the 5As.

ADVISE the patient to quit.

Schroeder (2005), JAMA.

The 2A and R Intervention


10

Free State Resources

• Free State Tobacco Quit Line

• Free Patient and Provider Materials

• Free Training and Technical Assistance


11

WA State Tobacco Quit Line

• Free telephone counseling support and medication.

• A Quit Kit of stage and language appropriate materials.

• A personalized quit plan.

• Tools to cope with withdrawal symptoms.

• Medication decision support.

1-800-QUIT-NOW or 1-877-2NO-FUME


12

WA State Tobacco Quit Line

All adult residents in Washington have access to free telephone-based coaching and medications. In some cases, the overall benefit may be more if covered by Medicaid, their

employer or health plan.



13

Who is Covered?

Coverage from July 1, 2008 – June 30, 2009 (subject to change)

Services provided in Spanish and in over 100 additional languages.Fax Referral Program available for proactive outreach to tobacco users. Email [email protected] to request fax referral forms Updated regularly. Last updated: 9/02/2008. For the most recent coverage update, go to: http://www.tobaccoprc.org/TCRC/QuitLine.cfm.

Age Eligible Population Quit Line Program Limitations

Adults Specific Populations- Uninsured- Indian Health Services- Referred by Veteran’s Administration

Multiple-Call ProgramDetails: 1 participant-initiated call, 4 Quit Line-initiated callsStage appropriate “self-help” materials8 weeks of Nicotine Replacement Therapy (NRT), if appropriate

Enrollment once per year, but participant may call Quit Line as neededAge 18 and overPrepared to quit within 30 days OR already quit

Adults Residents with WA State Medicaid

Multiple-Call ProgramDetails: 1 participant-initiated call, 4 Quit Line-initiated callsStage appropriate “self-help” materials12 weeks of Nicotine Replacement Therapy (NRT) OR 12 weeks of buproprion or varenicline (with a prescription), if appropriate.

Adults Pregnant Women (regardless of insurance status)

Multiple-Call ProgramDetails: 1 participant-initiated call, 9 Quit Line-initiated callsPopulation-specific “self-help” materials8 weeks of NRT, if appropriate (only with Medical Override)

Adults Any Washington State resident (regardless of insurance status)Note: Some callers may be eligible for additional services through their employer, a community resource or their health plan.

1-Call ProgramDetails: 1 participant-initiated callStage appropriate “self-help” materialsIf prepared to quit in 30 days OR already quit, participant is eligible to receive a 2-week starter kit of NRT (if appropriate)

Multiple calls per year, but must be initiated by participantAge 18 and over

Age 17 & under

Youth (age 17 and under) 1-Call ProgramDetails: 1 participant-initiated callNo materials or NRT can be provided.

Multiple calls per year, but must be initiated by participantAge 17 and under


mailto:[email protected]

http://www.tobaccoprc.org/TCRC/QuitLine.cfm

http://www.tobaccoprc.org/TCRC/QuitLine.cfm


14

Fax Referral Program

• Allows you to refer patients to the Quit Line using a fax referral process.

Benefits:

- Saves Time and Resources

- Ensures Proactive Follow-up

- Eliminates Patient Barriers

- Creates Opportunity


15

Patient and Provider Resources


16

How to order?

To access directions go to: www.tobaccoprc.org/TCRC --> click on “Order Tobacco Cessation and/or Quit Line materials.

http://www.tobaccoprc.org/TCRC


17

TCRC Provider Training

On-Site Healthcare Provider Training

Online Training and e-Learning

www.2AandR.org

Quit Line

Fax Referral

Brief Intervention

http://www.2aandr.org/


18

Online 2A and R Training

www.2AandR.org

http://www.2aandr.org/


19

Technical Assistance

Assistance helping organizations to:

• Set up systems to document tobacco use

• Develop tobacco cessation referral systems

• Tailor Electronic Medical Records

• Amend policies and procedures

• Implement smokefree campus policies


20

Upcoming Events

Webinar series (Winter, Spring 2009):

• Pharmacotherapy

• Reimbursement

• Setting up Systems to Identifying and Referring Tobacco Users


21

Questions / Discussion


22

Thank you!

[email protected]

206-876-2275

mailto:[email protected]

support for systems conducting tobacco cessation work gillian schauer, program manager, tcrc

Documents