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 改进将当前科学证据转化为临床实践，并改进最佳、 循证的、个性化的治疗。医疗保健提供者可以获得基于证据的指南， 帮助患者戒烟。然而，将这种知识和认识转化为日常实践仍然存在 很低。 这项临床随机试验将检查牙科提供者提供吸烟干预和 指的是当他们的EDR系统包括健康信息技术驱动的CDS时，与 在没有疾控中心帮助的情况下，控制诊所的提供者。提供者包括有经验的牙医和牙科医生 私人诊所的卫生员和牙科学校的博士前和牙科卫生专业的学生。初级阶段 结果是一个二元变量，指示提供者是否提供了简短的干预或推荐 治疗，如患者所报告的。其他结果包括患者自我报告的戒烟行为， 减少吸烟，戒烟。提供商级别的障碍、促进者和潜在机制 将对烟草CDS的影响进行核算。使用EDRS将当前证据转换为 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 作为戒烟的机会，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.