Abstract：
OBJECTIVE: Smoking is an important modifiable risk factor in all vascular diseases and verbal advice from providers has been shown to increase rates of tobacco cessation. We sought to identify factors that will improve tobacco cessation and recall of receiving verbal cessation advice in vascular surgery patients at a single institution.
METHODS: The study is a retrospective cohort study. Patients seen in outpatient vascular surgery clinic who triggered a tobacco Best Practice Advisory (BPA) during their office visits over a 10-month period were contacted post-clinic and administered surveys detailing smoking status, cessation advice recall, and validated scales for nicotine dependence and willingness to quit smoking. This BPA is a \"hard stop\" that requires providers to document actions taken. Charts were reviewed for tobacco cessation documentation. Nine-digit zip-codes identified the area deprivation index, a measure of socioeconomic status. Univariate analysis was used to identify factors associated with cessation and advice recall.
RESULTS: One hundred out of 318 (31.4%) patients responded to the survey. Epic Slicer Dicer found 97 BPA responses. To dismiss the BPA, 89 providers (91.8%) selected \"advised tobacco cessation\" and \"Unable to Advise\" otherwise. Of the 318 patients, 115 (36.1%) had cessation intervention documented in their provider notes and 151 (47.5%) received written tobacco cessation advice. Of survey respondents, 70 recalled receiving verbal advice, 27 recalled receiving written advice, 28 reported receiving offers of medication/therapy for cessation. 55 patients reported having tobacco cessation plans, and among those 17 reported having quit tobacco. Recall of receiving written advice (P < .001) and recall of receiving medication/therapy (P = .008) were associated with recall of receiving verbal cessation advice.
CONCLUSIONS: Providing patients with tobacco cessation medication/therapy and written tobacco cessation education during office visits is associated with increased patients\' recall of tobacco cessation advice. Vascular surgeons should continue to provide directed tobacco cessation advice.
METHODS: The study is a retrospective cohort study. Patients seen in outpatient vascular surgery clinic who triggered a tobacco Best Practice Advisory (BPA) during their office visits over a 10-month period were contacted post-clinic and administered surveys detailing smoking status, cessation advice recall, and validated scales for nicotine dependence and willingness to quit smoking. This BPA is a \"hard stop\" that requires providers to document actions taken. Charts were reviewed for tobacco cessation documentation. Nine-digit zip-codes identified the area deprivation index, a measure of socioeconomic status. Univariate analysis was used to identify factors associated with cessation and advice recall.
RESULTS: One hundred out of 318 (31.4%) patients responded to the survey. Epic Slicer Dicer found 97 BPA responses. To dismiss the BPA, 89 providers (91.8%) selected \"advised tobacco cessation\" and \"Unable to Advise\" otherwise. Of the 318 patients, 115 (36.1%) had cessation intervention documented in their provider notes and 151 (47.5%) received written tobacco cessation advice. Of survey respondents, 70 recalled receiving verbal advice, 27 recalled receiving written advice, 28 reported receiving offers of medication/therapy for cessation. 55 patients reported having tobacco cessation plans, and among those 17 reported having quit tobacco. Recall of receiving written advice (P < .001) and recall of receiving medication/therapy (P = .008) were associated with recall of receiving verbal cessation advice.
CONCLUSIONS: Providing patients with tobacco cessation medication/therapy and written tobacco cessation education during office visits is associated with increased patients\' recall of tobacco cessation advice. Vascular surgeons should continue to provide directed tobacco cessation advice.
摘要：
目的：吸烟是所有血管疾病中重要的可改变的危险因素，提供者的口头建议已被证明可以增加戒烟率。我们试图确定在单一机构中改善血管手术患者戒烟和接受口头戒烟建议的因素。
方法：本研究为回顾性队列研究。在门诊血管外科诊所就诊的患者在10个月的时间内，在诊所就诊期间触发了烟草最佳实践咨询（BPA），并在诊所后进行了详细调查，停止建议召回，并验证了尼古丁依赖和戒烟意愿的量表。此BPA是一个“硬停止”，要求提供商记录所采取的行动。审查了戒烟文件的图表。九位邮政编码确定了区域剥夺指数，衡量社会经济地位的标准。使用单变量分析来确定与停止和建议回忆相关的因素。
结果：318名患者中有100名（31.4%）对调查做出了回应。EpicSlicerDicer发现了97个BPA响应。解雇BPA，89名提供者(91.8%)选择了“建议戒烟”和“无法建议”。在318名患者中，115（36.1％）在其提供者说明中记录了戒烟干预措施，151（47.5％）接受了书面戒烟建议。在调查受访者中，70人回忆起收到口头建议，27回忆起收到书面建议，28人报告接受了停止药物/治疗的提议。55名患者报告有戒烟计划，在这17名报告已经戒烟的人中。接受书面建议的回忆（P<.001）和接受药物/治疗的回忆（P=.008）与接受口头戒断建议的回忆有关。
结论：在就诊期间为患者提供戒烟药物/治疗和书面戒烟教育与增加患者对戒烟建议的回忆有关。血管外科医师应继续提供有针对性的戒烟建议。
方法：本研究为回顾性队列研究。在门诊血管外科诊所就诊的患者在10个月的时间内，在诊所就诊期间触发了烟草最佳实践咨询（BPA），并在诊所后进行了详细调查，停止建议召回，并验证了尼古丁依赖和戒烟意愿的量表。此BPA是一个“硬停止”，要求提供商记录所采取的行动。审查了戒烟文件的图表。九位邮政编码确定了区域剥夺指数，衡量社会经济地位的标准。使用单变量分析来确定与停止和建议回忆相关的因素。
结果：318名患者中有100名（31.4%）对调查做出了回应。EpicSlicerDicer发现了97个BPA响应。解雇BPA，89名提供者(91.8%)选择了“建议戒烟”和“无法建议”。在318名患者中，115（36.1％）在其提供者说明中记录了戒烟干预措施，151（47.5％）接受了书面戒烟建议。在调查受访者中，70人回忆起收到口头建议，27回忆起收到书面建议，28人报告接受了停止药物/治疗的提议。55名患者报告有戒烟计划，在这17名报告已经戒烟的人中。接受书面建议的回忆（P<.001）和接受药物/治疗的回忆（P=.008）与接受口头戒断建议的回忆有关。
结论：在就诊期间为患者提供戒烟药物/治疗和书面戒烟教育与增加患者对戒烟建议的回忆有关。血管外科医师应继续提供有针对性的戒烟建议。
