Computer-Assisted Guidance for Tobacco Dependence Interventions in Dental Offices

描述(由申请人提供)： 本申请涉及广泛的挑战领域(05)比较有效性研究和特定挑战主题(05-DE-102)牙科环境中烟草和药物依赖的治疗。电子牙科记录(EDR)是一种潜在的强大工具，通过在患者护理时提供关键信息，将当前的科学证据纳入临床实践。我们知道，传播循证指南不足以改变临床实践，因此创新方法需要在牙科进行测试。研究人员和顾问在这个项目上的综合专业知识，以及使用一个EDR的多个诊所的大型团体实践，对于实现本研究的目标是必不可少的。该项目将研究牙医和卫生员是否会评估戒烟兴趣，并在提供计算机辅助指导的情况下比对照组更频繁地进行烟草干预。具体地说，我们将通过测量急诊室中这些活动的记录和患者通过电话调查接受这些建议的情况，来衡量评估变革意愿和基于变革意愿的适当干预措施的问题的交付情况。此外，这项研究将对患者对提供者-患者接触的感知价值进行定性评估，以进一步了解患者对这种互动的感知。我们想知道牙科提供者是否会在牙科治疗期间使用这些工具。如果它们被使用，我们将建议进一步研究戒烟率。由于这一筹资机制的两年时间线很短，我们无法衡量戒毒率。这一工具有可能应用于其他临床课题，这使得这种方法在考虑将证据转化为牙科独特的临床实践时非常具有创新性。这项研究将修改现有的电子牙科记录，为牙医和牙齿卫生员提供建议，为他们的患者吸烟。吸烟总体上对健康有重大影响，但它也会导致牙周病和口腔癌。我们将检查拥有这些工具的牙科提供者是否比没有这些工具的提供者提供更多的烟草干预。

DESCRIPTION (provided by applicant): This application addresses broad Challenge Area (05) Comparative Effectiveness Research and specific Challenge Topic (05-DE-102) treatment of tobacco and drug dependence in dental settings. Electronic dental records (EDR) are a potentially powerful tool to incorporate current scientific evidence into clinical practice by providing key information at the point of patient care. We know that disseminating evidence- based guidelines is not sufficient to change clinical practice so innovative approaches need to be tested in dentistry. The composite expertise of the investigators and consultants on this project and a large group practice with multiple clinics utilizing one EDR are essential to address the aims of this study. This project will examine whether dentists and hygienists will assess interest in quitting and deliver a tobacco intervention more frequently when provided with computer assisted guidance compared to a control group. Specifically we will measure the delivery of questions assessing willingness to change and appropriate interventions based on willingness to change by measuring the recording of these activities in the EDR and patient receipt of these recommendations through a phone survey. In addition, the study will do a qualitative assessment of the patient perceived value of the provider-patient encounter to further inform us about patient perception of this interaction. We want to know if dental providers will utilize these tools during the dental encounter. If they are used, we would propose further studies examining smoking cessation rates. We were not able to measure cessation rates due to the short two year timeline of this funding mechanism. This tool has potential application for other clinical topics, which makes this approach very innovative when considering the translation of evidence into the unique clinical practice of dentistry. This study will modify an existing electronic dental record to create recommendations for dentists and dental hygienists to provide for their patients that smoke. Smoking has major impact on health in general but it also causes gum disease and oral cancer. We will examine if dental providers with these tools provide more tobacco interventions compared to providers who do not have these tools.