In a study reported in the Journal of Oncology Practice, Singer et al found that a quality improvement initiative was successful in increasing a radiation oncology department’s efforts in encouraging patients with cancer to cease tobacco use prior to radiation therapy. As noted by the investigators, continued tobacco use in patients treated with radiation therapy is associated with poorer outcomes and increased treatment-related toxicity.
The study was performed in an academic center in an urban location with 13 radiation oncology residents. The intervention consisted of efforts to identify barriers to tobacco cessation practices; improve resident-led efforts to overcome these barriers; provide education on how to assess patient readiness to quit; and provide cost-effective educational materials on tobacco cessation to patients and staff. A financial incentive was offered to residents if the frequency of assessment of readiness to quit improved to ≥ 50% of new consultations in at least 3 of 4 quarters after start of the initiative.
Effect of Initiative
Between December 2014 and February 2015, before the initiation of the initiative, 4% of patients were assessed for their readiness to quit tobacco. After implementation of the initiative, between July 2015 and June 2016, 67% of 118 patients were assessed for readiness to quit; percentages for each successive 3-month quarter during the 1st year of implementation were 63%, 57%, 76%, and 52%. In the consultations in which readiness to quit was assessed, readiness to quit was expressed by 33 (43%) of 77 patients.
The investigators concluded, “After instituting a [quality improvement] initiative at our institution, significantly more patients were assessed for readiness to quit tobacco before treatment with radiation therapy. Ongoing efforts in our department are aimed at improving the efficacy of this intervention.”
Lisa Singer, MD, PhD, of the Department of Radiation Oncology, Brigham and Women’s Hospital, is the corresponding author for the Journal of Oncology Practice article.
Disclosure: The study was funded by the University of California, San Francisco, Resource Allocation Program for Trainees, Pathways to Discovery Project Grant. The study authors’ full disclosures can be found at jop.ascopubs.org.
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