A new study reveals cancer patients who smoke are more likely to receive evidence-based cessation assistance using the ELEVATE program, which increases the likelihood of better outcomes.
PLYMOUTH MEETING, Pa., May 11, 2022 /PRNewswire/ — New research in the May 2022 problem of JNCCN—Journal of the National Comprehensive Cancer Network finds that including Epic’s Electronic Health Record-Enabled Evidence-Based Smoking Cessation Treatment (ELEVATE) smoking cessation tool in electronic health records (EHRs) can increase smoking cessation rates self-reported by patients by more than 5 percentage points. The study, carried out by researchers from the Siteman Cancer Center at Barnes-Jewish Hospital and University of Washington The medical school—an NCCN member institution—was part of the National Cancer Institute’s (NCI) Cancer Moonshot program through the center’s Cancer Cessation Initiative.
Active smoking after a cancer diagnosis is associated with poorer outcomes, lower survival rates, higher risk of additional cancers, and more frequent and severe side effects of cancer treatment. The oncology community agrees that it’s never too late to quit smoking. However, far too many patients do not receive adequate counseling and support according to evidence-based smoking cessation guidelines.
“ELEVATE appears to be emerging as a relatively rare example of a program that provides access to high-quality smoking cessation care while minimizing cost and burden,” said lead researcher, Alex T. RamseyPhD, a University of Washington researcher at the Siteman Cancer Center. “ELEVATE offers an easy-to-use smoking module integrated with the electronic health record that shows the actions of multiple members of the oncology care team to assess smoking status, provide cessation counseling, prescribe cessation medications, and offer a variety of cessation counseling options for patients who smoke.”
“We need to ensure that oncology providers are fully supported by the entire healthcare team and have access to effective EHR decision support,” explained the lead researcher. Li-Shiun, Chen, MD, MPH, ScD, also with Siteman and University of Washington. “We have been pleasantly surprised at how eager oncology providers are to transform their practice to offer tobacco treatment as part of routine care, as long as this evidence-based care is integrated into their workflow and their EHR. ELEVATE offers an innovative, low-burden paradigm shift solution so that smoking cessation strategies can be fully integrated at the point of care for every oncology visit.”
A total of 3,238 EHR-documented medical oncology patients with current smoking status were studied during the pre-implementation period (January to May 2018) and the post-implementation period (June to December 2018). During subsequent 6-month follow-up periods, 12% of those treated before ELEVATE implementation had documented smoking cessation, compared to 17.2% of those treated after implementation.
The researchers also compared dropout rates in medical oncology patients versus surgical oncology patients and general internal medicine patients at University of Washington during the same periods, who did not have access to the ELEVATE program during these two periods. This population group consisted of 9,719 patients who smoke without a known cancer diagnosis. They found no significant change in the smoking rate between the two periods for this non-cancer group.
“Abstinence from smoking is an essential part of cancer care,” commented Christine E.ShefferPhD, Roswell Park Comprehensive Cancer Center, who did not participate in this research. “The results of this quasi-experimental pre-post study, conducted from 2018 to 2019, demonstrate the utility of using an EHR-based cessation tool to reach cancer patients with a moderate intervention for smoking cessation.”
Dr. Sheffer, member of the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) Panel for Smoking Cessation continued, “Although the proportion of patients with a reported period of abstinence within 6 months of the intervention has increased significantly, it remains below the requirement to provide effective long-term smoking cessation treatment as a critical step Combining an EHR-enabled cessation tool with NCCN-recommended counseling and pharmacotherapy has the potential to further increase the proportion of patients who achieve and maintain abstinence from smoking.
NCCN guidelines® The Panel for Smoking Cessation is comprised of multidisciplinary experts in topics including oncology, psychology, pulmonary medicine, and supportive care, drawn from NCCN’s 32 member institutions. Their recommendations are freely available for non-commercial use at NCCN.org or through the NCCN Guidelines Virtual Library.® App.
Tips for quitting smoking are also included in the NCCN Guidelines for specific types of cancer. A study in the March 2022 problem of Journal of Urology found that the NCCN Guidelines were the only clinical practice guidelines to include recommendations for tobacco screening and smoking cessation for bladder cancer, and were one of a very small group to provide both recommendations as part of their guidelines for non-small cell lung cancer.
To read the full ELEVATE study, visit JNCCN.org. Free access to “Increased Reach and Effectiveness with a Point-of-Care Low Burden Tobacco Treatment Program in Cancer Clinics” is available through August 10, 2022.
On JNCCN—Journal of the National Comprehensive Cancer Network
More than 25,000 oncologists and other cancer professionals across United States Lily JNCCN—Journal of the National Comprehensive Cancer Network. This peer-reviewed, indexed medical journal provides the latest information on innovation in translational medicine and scientific studies related to health services research in oncology, including quality care and value, bioethics, cancer, health effectiveness and cost-effectiveness, public policy and intervention research on supportive care. and survival. JNCCN presents updates to the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®), review articles elaborating on guideline recommendations, health services research and case reports highlighting molecular knowledge in patient care. JNCCN is published by Harborside. Visit JNCCN.org. To find out if you qualify for a FREE subscription to JNCCN, visit NCCN.org/jnccn/subscribe. To follow JNCCN on Twitter @JNCCN.
About the Comprehensive National Cancer Network
The Comprehensive National Cancer Network® (NCCN®) is a non-profit alliance of leading cancer centers devoted to patient care, research and education. NCCN is dedicated to improving and facilitating quality, effective, equitable, and accessible cancer care so that all patients can live a better life. The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) provide transparent, evidence-based and expert consensus recommendations for cancer treatment, prevention and support services; they are the recognized standard for clinical guidance and policy in cancer management and the most comprehensive and frequently updated clinical practice guidelines available in all fields of medicine. the NCCN Guidelines for Patients® provide expert information on cancer treatment to inform and empower patients and caregivers, with support from the NCCN Foundation®. The NCCN is also progressing continuing education, global initiatives, Politicsand research collaboration and publication in oncology. Visit NCCN.org for more information and follow NCCN on Facebook @NCCNorg, Instagram @NCCNorg and Twitter @NCCN.
SOURCE Comprehensive National Cancer Control Network