Table 9Evaluation of the Added Effect of the TMCP Training on Tobacco-Cessation Support Outcomes

1-3 mo before AACAAC onlyAAC+TMCPaAAC+TMCP among clinicians who used the document flow sheet
No.%OR (95% CI)No.%OR (95% CI)No.%OR (95% CI)No.%OR (95% CI)b
Total visits 20 469 77 500 41 774 661
 % of patients asked561827.5–38 68749.92.76 (2.67-2.86)26 45263.31.73 (1.70-1.77)49274.41.89 (1.62-2.20)
Visits by smokers 1744 13 342 8198 466
 % of visits in which patients were advised77844.6–11 32384.94.35 (3.79-5.00)746691.11.97 (1.81-2.14)44395.13.21 (2.19-4.72)
 % of visits in which patients were assessed for readiness to quit22613.0–884866.312.34 (10.67-14.27)468457.10.66 (0.62-0.69)34774.51.24 (1.00-1.54)
 Ready to quit (No. of visits)1152690107393
Acceptance of referral during visits
 % of visits in which patient accepted a referral10.9–117643.783.20 (12.58-550.36)36934.40.66 (0.57-0.77)4346.21.00 (0.66-1.51)
 % of visits in which patient accepted QL referral00.0–82730.7NA25223.50.68 (0.58-0.80)2223.70.71 (0.45-1.14)
 % of visits in which patient accepted FFS referral10.9–34913.014.89 (2.50-88.70)11710.90.79 (0.64-0.98)2122.61.45 (0.85-2.49)
Ready to quit (No. of patients) 112 2239 1001 93
 Patients who accepted referral10.9–108948.677.67 (13.10-460.61)35735.70.59 (0.47-0.74)4346.20.80 (0.50-1.29)
 Patients who accepted QL referral00.0–76534.2NA24724.70.64 (0.50-0.82)2223.70.58 (0.38-0.90)
 Patients who accepted FFS referral10.9–32814.714.47 (2.88-72.66)11211.20.74 (0.58-0.95)2122.61.42 (0.86-2.34)
QL referrals received 649 200 15
 Contact rateNA21132.5NA4422.00.58 (0.36-0.95)320.00.53 (0.18-1.55)
 Enrollment rateNA15874.9NA2965.90.65 (0.35-1.23)133.30.15 (0.01-1.96)
FFS referrals received 0 – 276 106 21
 Contact rateNA–7527.2NA2321.70.82 (0.53-1.26)523.81.00 (0.46-2.18)
 Enrollment rateNA–5066.7NA1878.31.74 (0.47-6.40)360.00.79 (0.12-5.18)
Medications 1137.9–112614.91.85 (1.53-2.23)71812.40.81 (0.74-0.88)13931.62.61 (1.92-3.55)
Quit attemptsc 512.5–442.10.82 (0.54-1.23)452.31.09 (0.72-1.67)83.71.95 (0.86-4.45)

Abbreviations: AAC, Ask-Advise-Connect; FFS, Freedom From Smoking; NA, not applicable; QL, quitline; TMCP, Teachable Moment Communication Process.

aComparison is the post-TMCP to post-AAC period among clinicians who received training.

bComparison is post-TMCP for visits in which a document flow sheet was used compared with visits during the post-AAC period for clinicians who had ever used the document flow sheet.

cQuit attempts are defined based on ≥2 visits in the time period, a change in smoking status from current smoker to former smoker, and documentation of a quit date. Numerator and denominator for quit attempts for each period: 51/1986 (1-3 mo before AAC), 44/2088 (AAC only), 45/1951 (AAC+TMCP), and 8/216 (AAC+TMCP among clinicians who used the document flow sheet).

From: Adding a Teachable Moment Approach to a Team-Based Primary Care Ask-Advise-Connect Approach for Tobacco Cessation

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Adding a Teachable Moment Approach to a Team-Based Primary Care Ask-Advise-Connect Approach for Tobacco Cessation [Internet].
Flocke S, Seeholzer E, Love T, et al.
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