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

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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.