Sophia Papadakis1,2,3, Adam G Cole4, Robert D Reid5,2, Roxane Assi5, Marie Gharib5, Heather E Tulloch5, Kerri-Anne Mullen5, George Wells2,6, Andrew L Pipe5,2. 1. Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Ontario, Canada SPapadakis@ottawaheart.ca. 2. Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada. 3. Clinic of Social and Family Medicine, University of Crete, Rethymnon, Crete, Greece. 4. School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada. 5. Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Ontario, Canada. 6. Research Methods Centre, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
Abstract
PURPOSE: The purpose of this study was to examine the incremental effect of performance coaching, delivered as part of a multicomponent intervention (Ottawa Model for Smoking Cessation [OMSC]), in increasing rates of tobacco-dependence treatment by primary care clinicians. METHODS: In a cluster-randomized controlled trial, 15 primary care practices were randomly assigned to 1 of the following active-treatment conditions: OMSC or OMSC plus performance coaching (OMSC+). All practices received support to implement the OMSC. In addition, clinicians in the OMSC+ group participated in a 1.5-hour skills-based coaching session and received an individualized performance report. All clinicians and a cross-sectional sample of their patients were surveyed before and 4 months after introduction of the interventions. The primary outcome measure was rates of tobacco-dependence treatment strategy (Ask, Advise, Assist, Arrange) delivery. Secondary outcomes were patient quit attempts and smoking abstinence measured at 6 months' follow-up. RESULTS:Primary care clinicians (166) and patients (1,990) were enrolled in the trial. Clinicians in the OMSC+ group had statistically greater rates of delivery for Ask (adjusted odds ratio [AOR] = 1.69; 95% CI, 1.05-2.72), Assist (AOR = 1.64; 95% CI, 1.08-2.49), and Arrange (AOR = 2.01; 95% CI, 1.22-3.31). Sensitivity analysis found that the rate of delivery for Advise was greater only among those clinicians who attended the coaching session (AOR = 1.65; 95% CI, 1.10-2.49; P = .02). No differences were documented between groups for cessation outcomes. CONCLUSIONS:Performance coaching significantly increased rates of tobacco-dependence treatment by primary care clinicians when delivered as part of a multicomponent intervention.
RCT Entities:
PURPOSE: The purpose of this study was to examine the incremental effect of performance coaching, delivered as part of a multicomponent intervention (Ottawa Model for Smoking Cessation [OMSC]), in increasing rates of tobacco-dependence treatment by primary care clinicians. METHODS: In a cluster-randomized controlled trial, 15 primary care practices were randomly assigned to 1 of the following active-treatment conditions: OMSC or OMSC plus performance coaching (OMSC+). All practices received support to implement the OMSC. In addition, clinicians in the OMSC+ group participated in a 1.5-hour skills-based coaching session and received an individualized performance report. All clinicians and a cross-sectional sample of their patients were surveyed before and 4 months after introduction of the interventions. The primary outcome measure was rates of tobacco-dependence treatment strategy (Ask, Advise, Assist, Arrange) delivery. Secondary outcomes were patient quit attempts and smoking abstinence measured at 6 months' follow-up. RESULTS: Primary care clinicians (166) and patients (1,990) were enrolled in the trial. Clinicians in the OMSC+ group had statistically greater rates of delivery for Ask (adjusted odds ratio [AOR] = 1.69; 95% CI, 1.05-2.72), Assist (AOR = 1.64; 95% CI, 1.08-2.49), and Arrange (AOR = 2.01; 95% CI, 1.22-3.31). Sensitivity analysis found that the rate of delivery for Advise was greater only among those clinicians who attended the coaching session (AOR = 1.65; 95% CI, 1.10-2.49; P = .02). No differences were documented between groups for cessation outcomes. CONCLUSIONS: Performance coaching significantly increased rates of tobacco-dependence treatment by primary care clinicians when delivered as part of a multicomponent intervention.
Authors: Charles J Bentz; K Bruce Bayley; Kerry E Bonin; Lori Fleming; Jack F Hollis; Jacquelyn S Hunt; Benjamin LeBlanc; Tim McAfee; Nicola Payne; Joseph Siemienczuk Journal: Nicotine Tob Res Date: 2007-03 Impact factor: 4.244
Authors: Robert D Reid; Kerri-Anne Mullen; Monika E Slovinec D'Angelo; Debbie A Aitken; Sophia Papadakis; Patricia M Haley; Christine A McLaughlin; Andrew L Pipe Journal: Nicotine Tob Res Date: 2009-11-10 Impact factor: 4.244
Authors: Amy Larkin; Michael LaCouture; Kathleen Geissel; Peri Barr; Eric R Bates; Christopher P Cannon; Deepak L Bhatt Journal: Crit Pathw Cardiol Date: 2017-09
Authors: Anne M Joseph; Nancy J Arikian; Larry C An; Sean M Nugent; Richard J Sloan; Carl F Pieper Journal: Med Care Date: 2004-11 Impact factor: 2.983
Authors: Sophia Papadakis; Andrew L Pipe; Robert D Reid; Heather Tulloch; Kerri-Anne Mullen; Roxane Assi; Adam G Cole; George Wells Journal: Contemp Clin Trials Date: 2015-09-05 Impact factor: 2.226