Accelerating integration of tobacco use treatment in the context of lung cancer screening: Relevance and application of implementation science to achieving policy and practice.
Accelerating integration of tobacco use treatment in the context of lung cancer screening: Relevance and application of implementation science to achieving policy and practice.
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DOI：
10.1093/tbm/ibac076
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发表时间：
2022-11-21
影响因子：
3.6
通讯作者：
Ostroff, Jamie S.
中科院分区：
文献类型：
--
作者：
Shelley, Donna;Wang, Vivian Hsing-Chun;Taylor, Kathryn;Williams, Randi;Toll, Benjamin;Rojewski, Alana;Foley, Kristie L.;Rigotti, Nancy;Ostroff, Jamie S.
根据国家肺部筛查试验的结果，美国预防服务工作组建议在高危成年人中进行年度低剂量计算机断层扫描(LDCT)肺癌筛查。大约54%的寻求LCS的人报告说目前吸烟。在LCS期间提供的有效戒烟干预措施增强了筛查的健康益处，这可归因于肺癌总体和与烟草相关的死亡率的降低。考虑到这些数据，医疗保险和医疗补助服务中心(CMS)2015年决定用LDCT覆盖LCS，要求放射成像设施为吸烟者提供戒烟干预。2022年2月，CMS取消了2015年在LDCT时提供烟草使用治疗的覆盖要求；CMS在考试前的共享决策访问期间保留了咨询要求。这一政策变化并没有降低在为LCS提供常规LDCT的同时提供高质量戒烟服务的重要性。然而，LCS方案在其环境中实施烟草使用治疗面临一系列障碍。因此，实施工作一直滞后。缩小“证据到实践”的差距是实施科学的重点，该领域提供了一套严格的方法和系统的方法，以确定和克服在一系列临床环境中实施循证指南的背景障碍。在这篇文章中，我们描述了如何使用实施科学框架和方法来帮助指导LCS方案整合烟草使用治疗的努力，并讨论了进一步促进将TUT作为LCS进程的一个重要组成部分交付所需的政策变化。在肺癌筛查时结合烟草使用治疗将拯救生命。
Based on the findings from the National Lung Screening Trial, the U.S. Preventive Services Task Force recommends annual low dose computed tomography (LDCT) lung cancer screening (LCS) among high-risk adults. Approximately 54% of individuals seeking LCS report current cigarette smoking. Effective smoking cessation interventions, offered at the time of LCS, enhances the health benefits of screening that are attributable to reductions in lung cancer overall and tobacco-related mortality. Considering these data, the Centers for Medicare & Medicaid Services’ (CMS) 2015 decision to cover LCS with LDCT required that radiology imaging facilities make tobacco cessation interventions available for people who smoke. In February 2022, CMS reversed their 2015 coverage requirement for delivering tobacco use treatment at the time of LDCT; CMS retained the requirement for counseling during the shared decision-making visit prior to the exam. The policy change does not diminish the importance of offering high-quality tobacco cessation services in conjunction with routine LDCT for LCS. However, LCS programs face a range of barriers to implementing tobacco use treatment in their settings. As a result, implementation has lagged. Closing the “evidence to practice” gap is the focus of implementation science, a field that offers a set of rigorous methods and a systematic approach to identifying and overcoming contextual barriers to implementing evidence-based guidelines in a range of clinical settings. In this paper, we describe how implementation science frameworks and methods can be used to help guide LCS programs in their efforts to integrate tobacco use treatment and discuss policy changes needed to further facilitate the delivery of TUT as an essential component of the LCS process. Integrating tobacco use treatment at the time of lung cancer screening will save lives.
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DOI：
10.1186/1748-5908-4-50
发表时间：
2009-08-07
期刊：
Implementation science : IS
影响因子：
--
作者：
Damschroder LJ;Aron DC;Keith RE;Kirsh SR;Alexander JA;Lowery JC
通讯作者：
Lowery JC
影响因子：
7.2
作者：
Birken, Sarah A.;Bunger, Alicia C.;Weiner, Bryan J.
通讯作者：
Weiner, Bryan J.
影响因子：
5.7
作者：
Heffner, Jaimee L.;Coggeshall, Scott;Zeliadt, Steven B.
通讯作者：
Zeliadt, Steven B.
影响因子：
3.6
作者：
Khanna, Niharika;Klyushnenkova, Elena;Wolfe, Sara
通讯作者：
Wolfe, Sara
影响因子：
5.2
作者：
D'Angelo, Heather;Ramsey, Alex T.;Baker, Timothy B.
通讯作者：
Baker, Timothy B.