A Clinic-Randomized Trial of a Clinical Decision Support System to Improve Dental Provider Delivery of Brief Tobacco Interventions and Quitline Referrals

项目摘要 在电子牙科记录系统（EDRs）中使用临床决策支持（CDS）具有很大的潜力， 改善当前科学证据向临床实践的转化， 基于证据的个性化治疗卫生保健提供者可以获得循证指南， 帮助患者戒烟。然而，将这些知识和意识转化为日常实践仍然存在 低 这项临床随机试验将检查牙科提供者提供吸烟干预的比率， 当他们的EDR系统包括健康信息技术驱动的CDS时， 在没有CDS帮助的情况下，控制诊所的提供者。提供者包括经验丰富的牙医和牙科 私人诊所的牙医和牙科学校的博士预科生和牙科卫生学生。主 outcome是一个二进制变量，指示提供者是否提供了简短的干预或转诊， 根据患者报告的治疗。其他结果包括患者自我报告的戒烟行动， 减少吸烟和戒烟。提供者一级的障碍、促进者和潜在机制 将研究烟草CDS的影响。使用EDR将现有证据转化为 牙科实践具有很大的潜力，但在临床培训和实践中都没有实现。通过利用 牙科就诊作为提供戒烟的机会，我们可以进一步降低吸烟率， 从而改善人口健康。

Project Summary Use of clinical decision support (CDS) within electronic dental record systems (EDRs) holds much potential to improve the translation of current scientific evidence into clinical practice and improve the delivery of optimal, evidence-based, personalized treatment. Health care providers have access to evidence-based guidelines that help patients quit smoking. Translation of that knowledge and awareness into daily practice, however, remains low. This clinic-randomized trial will examine the rate at which dental providers deliver a smoking intervention and refer to a quitline when their EDR system includes health information technology-driven CDS compared with providers in control clinics without assistance from the CDS. Providers include experienced dentists and dental hygienists in private practices and predoctoral and dental hygiene students in dental schools. The primary outcome is a binary variable indicating whether the provider delivered a brief intervention or referral for treatment, as reported by the patient. Additional outcomes include patient self-reported actions toward quitting, smoking reduction, and smoking cessation. Provider-level barriers, facilitators, and potential mechanisms accounting for the effect of tobacco CDS will be examined. Using EDRs to translate current evidence into dental practice holds much potential yet is unrealized in both clinical training and practice. By leveraging the dental encounter as an opportunity to deliver smoking cessation, we can further decrease smoking rates, leading to improved population health.