A controlled cluster randomized pilot study of the effect of a new smoking cessation management module on rates of initiation and continuation of smoking counselling in Ontario primary care practices using P-PROMPT Chronic Disease Management System (CDMS)
Date of Award
Master of Science (MS)
Health Research Methodology
Rolf J. Sebaldt
Multi-faceted interventions that include some form of a clinical information system have been shown to improve primary care physicians' management of chronic diseases. The objective of this pilot study was to assess the feasibility of a cluster randomized controlled trial of a multi-faceted intervention, which includes a clinical information system, to improve the management of the chronic disease of tobacco use by physicians. Feasibility was assessed with respect to the use of a measurement tool (Smoking Status Identification Card) and use of a new smoking cessation management module in the clinical information system.
Letters of invitation were sent out to the 65 primary care physicians (in 38 primary care practices) who were subscribed to the web-based clinical information system (P-PROMPT CDMS). Five physicians from 5 primary care practices agree.d to participate, who were stratified and then randomized to the intervention (2 primary care practices) or control group (3 primary care practices).
Following the 12-week study period, SSIC completion reached the 90% threshold success criterion in 2 of the 5 primary care practices (one each from the intervention and control group). The intervention group demonstrated basic use of the new smoking cessation management module that reached 21.9% and 19.0% in each of the respective practices, which was below the 30% threshold success criterion. A preliminary evaluation of physician delivery of smoking cessation counselling demonstrated a trend to a higher percentage of Ministry of Health and Long-Term Care (MOHLTC) physician service billing codes submitted among the physicians in the intervention group, which may be indicative of greater smoking cessation counselling.
It is concluded that a randomized controlled trial to test a multi-faceted intervention is not feasible with the current study design. Significant modifications to the current study design are required that can potentially be tested prior to progression to a larger trial.
MacLeod, Natalie T., "A controlled cluster randomized pilot study of the effect of a new smoking cessation management module on rates of initiation and continuation of smoking counselling in Ontario primary care practices using P-PROMPT Chronic Disease Management System (CDMS)" (2010). Open Access Dissertations and Theses. Paper 7198.
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