Electronic Proactive Outreach for Smokers with COPD: Engaging patients to quit

针对慢性阻塞性肺病吸烟者的电子主动外展：鼓励患者戒烟

• 批准号: 10689727
• 负责人: Anne Catherine Melzer
• 金额: --
• 依托单位: MINNEAPOLIS VA MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-08-01 至 2025-09-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10689727
• 关键词: Address; Adoption; Affect; Area; Award; Behavioral; Caring; Cause of Death; Chronic Disease; Chronic Obstructive Pulmonary Disease; Communication Methods; Consolidated Framework for Implementation Research; Cost Analysis; Counseling; Data; Development; Doctor of Philosophy; Effectiveness; Electronic Mail; Electronics; Enrollment; Evaluation; Evidence based treatment; Feedback; Future; Goals; Health; Health Promotion; Health Services; Health Services Research; Health Technology; Healthcare Systems; Intention; Intervention; Interview; Investigator-Initiated Research; K-Series Research Career Programs; Knowledge; Leadership; Medical; Mentors; Methods; Modeling; Nicotine Dependence; Outcome Assessment; Patient Participation; Patient Recruitments; Patients; Pharmaceutical Preparations; Pulmonology; Qualifying; Qualitative Research; Quality of Care; Randomized; Research; Research Activity; Research Methodology; Research Personnel; Research Project Grants; Research Proposals; Resources; Respiratory Disease; Respiratory Signs and Symptoms; Secure; Services; Site; Smoke; Smoker; Smoking; Surveys; Symptoms; Target Populations; Technology; Telephone; Testing; Tobacco; Tobacco Use Cessation; Tobacco Use Disorder; Tobacco use; Training; Veterans; Veterans Health Administration; Visit; Workload; behavior test; budget impact; care coordination; career; clinical care; comparative effectiveness trial; comparison intervention; cost; cost effective; design; evidence base; experience; future implementation; health information technology; high risk population; implementation efforts; implementation facilitators; implementation science; improved; individualized medicine; interest; low socioeconomic status; lung health; mHealth; outreach; outreach program; patient engagement; program costs; programs; prospective; recruit; response; skills; smoking cessation; sound; success; therapy development; tobacco abstinence; tobacco cessation intervention; tobacco control; training project; treatment as usual; treatment program

Overview: I am applying for a 5-year Career Development Award (CDA) to support my overarching goal of increasing smoking cessation among patients with respiratory diseases. This will be accomplished through the completion of mentored research activities and formal training designed to provide the skills necessary to become an independent investigator. During the course of my award, I will develop and test a program of proactive tobacco treatment for smokers with chronic obstructive pulmonary disease (COPD), delivered electronically and designed to increase participation in evidence-based tobacco treatments. Significance: COPD is one of the most common conditions cared for by the Veterans Health Administration and 90% of cases are directly attributable to smoking. Though the VA has made great strides in tobacco control, patients with COPD continue to smoke at rates double the overall VA average. Treatment for tobacco use disorder is the most impactful intervention for smokers with COPD. Unfortunately, smokers with COPD remain undertreated for tobacco use. Proactive tobacco treatment programs, where smokers are systematically identified outside of a routine visit, engaged in a cessation attempt, and connected to evidence- based treatment, have been found to be effective for increasing smoking cessation and use of quit support, and may be particularly beneficial for smokers with COPD. Proactive programs are rarely implemented, possibly due to high associated workload. Using electronic communication such as secure messaging to deliver this care may be effective without the cost and workload associated with previously tested telephone outreach programs. The intervention developed in this CDA proposal has the potential for wide-reaching impact, leveraging existing VA resources more efficiently to increase cessation in this high-risk population. Career Plan: My primary area of research has focused on identifying gaps in care quality for patients with COPD, particularly in tobacco cessation treatment. To successfully achieve my goals of improving utilization of tobacco treatment for smokers with COPD, I need further mentored training in implementation science including: qualitative and mixed methods, design and testing of behavioral tobacco interventions with a focus on mobile health, and cost analysis. I will achieve these objectives through formal coursework, seminars, and mentored research activities under the guidance of Steven Fu, MD MSCE (primary mentor, Minneapolis VA Health Care System [MVAHCS]), Hildi Hagedorn, PhD (MVAHCS) and David Au, MD MS (VA Puget Sound). Research Plan: My primary research objective is to develop and test an electronic proactive tobacco treatment program for smokers with COPD. To execute this goal, I will complete the following projects: 1) a mixed methods (survey and interview) assessment of current use of health information technology among smokers with COPD to (A) inform the creation of a proactive tobacco treatment program tailored to the target population (B) assess the association between the chronic disease state and intention to engage with the proactive program 2) a qualitative assessment of barriers and facilitators to implementation of proactive tobacco treatment programs for patients with COPD among staff and leadership to (A) understand the slow adoption of proactive tobacco treatment interventions and (B) inform future implementation efforts, 3) a randomized pilot of a proactive tobacco treatment program for smokers with COPD delivered through secure messaging and compared to usual care to (A) assess feasibility and (B) quantify the cost of the program. The proposed training and research projects will generate preliminary data necessary for development of a future Investigator-Initiated Research (IIR) proposal submitted in Year 3. I plan to propose a randomized comparative effectiveness trial comparing the intervention developed in this proposal to a previously tested telephone method for increasing tobacco abstinence, launching my career as an independent VA HSR&D investigator committed to improving Veterans’ health through enhanced access to tobacco cessation treatment.

概述：我正在申请一个5年的职业发展奖（CDA），以支持我的总体目标

项目成果

Pharmacist-Driven Deprescribing of Inhaled Corticosteroids in Patients with Stable Chronic Obstructive Pulmonary Disease.

药剂师主导的稳定慢性阻塞性肺疾病患者吸入皮质类固醇的处方减少。

• DOI: 10.1513/annalsats.202007-871rl
• 发表时间: 2021
• 期刊: Annals of the American Thoracic Society
• 影响因子: 8.3
• 作者: Hegland,AndreaJ;Bolduc,Jennifer;Jones,Lindsey;Kunisaki,KenM;Melzer,AnneC
• 通讯作者: Melzer,AnneC

The Chain of Adherence for Incidentally Detected Pulmonary Nodules after an Initial Radiologic Imaging Study: A Multisystem Observational Study.

初始放射成像研究后偶然检测到的肺结节的依从链：一项多系统观察研究。

• DOI: 10.1513/annalsats.202111-1220oc
• 发表时间: 2022
• 期刊: Annals of the American Thoracic Society
• 影响因子: 8.3
• 作者: Hedstrom,GradyH;Hooker,ElizabethR;Howard,Matthew;Shull,Sarah;Golden,SaraE;Deffebach,MarkE;Gorman,JohnD;Murphy,Katherine;Fabbrini,Angela;Melzer,AnneC;Slatore,ChristopherG
• 通讯作者: Slatore,ChristopherG

Policy Recommendations to Eliminate Tobacco Use and Improve Health from the American Thoracic Society Tobacco Action Committee.

美国胸科学会烟草行动委员会关于消除烟草使用和改善健康的政策建议。

• DOI: 10.1513/annalsats.202104-493ps
• 发表时间: 2022
• 期刊: Annals of the American Thoracic Society
• 影响因子: 8.3
• 作者: Eakin,MichelleN;Bauer,SarahE;Carr,Thomas;Dagli,Elif;Ewart,Gary;Garfield,JamieL;Jaspers,Ilona;Kher,Sucharita;Leone,FrankT;Melzer,AnneC;Moazed,Farzad;Moraes,TheoJ;Reddy,KrishnaP;Upson,Dona;Kathuria,Hasmeena
• 通讯作者: Kathuria,Hasmeena

Variation in Reporting of Incidental Findings on Initial Lung Cancer Screening and Associations With Clinician Assessment.

初始肺癌筛查的偶然发现报告的变化以及与临床医生评估的关联。

• DOI: 10.1016/j.jacr.2023.03.023
• 发表时间: 2024
• 期刊: Journal of the American College of Radiology : JACR
• 作者: Melzer,AnneC;Atoma,Bethlehem;Fabbrini,AngelaE;Campbell,Megan;Clothier,BarbaraA;Fu,StevenS
• 通讯作者: Fu,StevenS

Provision of Smoking Cessation Resources in the Context of In-Person Shared Decision-Making for Lung Cancer Screening.

在肺癌筛查面对面共同决策的背景下提供戒烟资源。

• DOI: 10.1016/j.chest.2021.03.016
• 发表时间: 2021
• 期刊: Chest
• 影响因子: 9.6
• 作者: Shen,Jolie;Crothers,Kristina;Kross,ErinK;Petersen,Kaylee;Melzer,AnneC;Triplette,Matthew
• 通讯作者: Triplette,Matthew