Abstract:
BACKGROUND:Fax referral services that connect smokers to state quitlines have been implemented in 49 U.S. states and territories and promoted as a simple solution to improving smoker assistance in medical practice. This study is an in-depth examination of the systems-level changes needed to implement and sustain a fax referral program in primary care. METHODS:The study involved implementation of a fax referral system paired with a chart stamp prompting providers to identify smoking patients, provide advice to quit and refer interested smokers to a state-based fax quitline. Three focus groups (n = 26) and eight key informant interviews were conducted with staff and physicians at two clinics after the intervention. We used the Chronic Care Model as a framework to analyze the data, examining how well the systems changes were implemented and the impact of these changes on care processes, and to develop recommendations for improvement. RESULTS:Physicians and staff described numerous benefits of the fax referral program for providers and patients but pointed out significant barriers to full implementation, including the time-consuming process of referring patients to the Quitline, substantial patient resistance, and limitations in information and care delivery systems for referring and tracking smokers. Respondents identified several strategies for improving integration, including simplification of the referral form, enhanced teamwork, formal assignment of responsibility for referrals, ongoing staff training and patient education. Improvements in Quitline feedback were needed to compensate for clinics' limited internal information systems for tracking smokers. CONCLUSIONS:Establishing sustainable linkages to quitline services in clinical sites requires knowledge of existing patterns of care and tailored organizational changes to ensure new systems are prioritized, easily integrated into current office routines, formally assigned to specific staff members, and supported by internal systems that ensure adequate tracking and follow up of smokers. Ongoing staff training and patient self-management techniques are also needed to ease the introduction of new programs and increase their acceptability to smokers.
journal_name
BMC Fam Practjournal_title
BMC family practiceauthors
Cantrell J,Shelley Ddoi
10.1186/1471-2296-10-81subject
Has Abstractpub_date
2009-12-17 00:00:00pages
81issn
1471-2296pii
1471-2296-10-81journal_volume
10pub_type
杂志文章abstract:BACKGROUND:The prevalence of coexisting chronic conditions (multimorbidity) is rising. Disease labels, however, give little information about impact on subjective health and personal illness experience. We aim to examine the strength of association of single and multimorbid physical chronic diseases with self-rated hea...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-014-0185-6
更新日期:2014-11-25 00:00:00
abstract:BACKGROUND:We undertook a systematic review of observational studies of depression in primary care to determine 1) the nature and scope of the published studies 2) the methodological quality of the studies; 3) the identified recovery and risk factors for persistent depression and 3) the treatment and health service use...
journal_title:BMC family practice
pub_type: 杂志文章,评审
doi:10.1186/1471-2296-8-28
更新日期:2007-05-11 00:00:00
abstract:BACKGROUND:Antibiotics are being overprescribed in ambulant care, especially for respiratory tract infections (RTIs). Gaining insight into the actual reasons for prescribing remains important for the design of effective strategies to optimise antibiotic prescribing. We aimed to determine items of importance for the ant...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-3-16
更新日期:2002-09-09 00:00:00
abstract:BACKGROUND:Patient safety in primary care is an emerging field of research with a growing evidence base in western countries but little has been explored in the Gulf Cooperation Council Countries (GCC) including the Sultanate of Oman. This study aimed to review the literature on the safety culture and patient safety me...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-018-0793-7
更新日期:2018-06-30 00:00:00
abstract:BACKGROUND:Depression is prevalent in people with type 2 diabetes and affects both glycemic control and overall quality of life. The aim of this trial was to evaluate the effect of the antidepressant paroxetine on metabolic control, quality of life and mental well-being in mildly depressed women with type 2 diabetes. ...
journal_title:BMC family practice
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1186/1471-2296-4-7
更新日期:2003-05-14 00:00:00
abstract:BACKGROUND:Intimate partner violence is highly prevalent and mostly affects women with negative consequences for their physical and mental health. Children often witness the violence which has negative consequences for their well-being too. Care offered by family physicians is often rejected because abused women experi...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-12-113
更新日期:2011-10-18 00:00:00
abstract:BACKGROUND:Home visits are part of general practice work in Germany. Within the context of an expanding elderly population and a decreasing number of general practitioner (GPs), open questions regarding the organisation and adequacy of GPs' care in immobile patients remain. To answer these questions, we will conduct a ...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-15-87
更新日期:2014-05-06 00:00:00
abstract:BACKGROUND:Many western countries are facing an existing or imminent shortage of primary care physicians especially in rural areas. In Germany, working in rural areas is often thought to be associated with more working hours, a higher number of patients and a lower income than working in urban areas. These perceptions ...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-12-112
更新日期:2011-10-11 00:00:00
abstract:BACKGROUND:Ischaemic heart disease and congestive heart failure are common and important conditions in family practice. Effective treatments may be underutilized, particularly in women and the elderly. The objective of the study was to determine the rate of prescribing of evidence-based cardiovascular medications and d...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-5-6
更新日期:2004-04-01 00:00:00
abstract:BACKGROUND:Over three-quarters of all suicides are men (England and Wales), this is despite higher levels of anxiety and depression being reported by women. This disparity may in part be explained by atypical presentations of distress in men, and gendered issues around help-seeking. Consequently, the Atlas Men's Well-b...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-016-0410-6
更新日期:2016-02-02 00:00:00
abstract:BACKGROUND:The QUALICOPC (Quality and Costs of Primary Care in Europe) study aims to evaluate the performance of primary care systems in Europe in terms of quality, equity and costs. The study will provide an answer to the question what strong primary care systems entail and which effects primary care systems have on t...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-12-115
更新日期:2011-10-20 00:00:00
abstract:BACKGROUND:There is increasing focus on patient-centred communicative approaches in medical consultations, but few studies have shown the extent to which patients' positive coping strategies and psychological assets are addressed by general practitioners (GPs) on a regular day at the office. This study measures the fre...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-10-49
更新日期:2009-07-01 00:00:00
abstract:BACKGROUND:Patients' expectations can influence antibiotic prescription by primary healthcare physicians. We assessed knowledge, attitude and practices towards antibiotic use for upper respiratory tract infections (URTIs), and whether knowledge is associated with increased expectations for antibiotics among patients vi...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-016-0547-3
更新日期:2016-11-03 00:00:00
abstract:BACKGROUND:It is commonplace for lay caregivers to overlook their own health concerns when supporting someone with advanced cancer. During this time, caregivers' needs as patients are often marginalised by health professionals, including General Practitioners (GPs), who may miss the breadth of caregivers' needs by focu...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-12-110
更新日期:2011-10-05 00:00:00
abstract:BACKGROUND:Over 60% of people have overweight or obesity, but only a third report receiving counselling from primary care providers. We explored patients' perspectives on the role of primary care in obesity management and their experience with existing resources, with a view to develop an improved understanding of this...
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更新日期:2017-02-08 00:00:00
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更新日期:2015-07-29 00:00:00
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journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-9-61
更新日期:2008-11-06 00:00:00
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journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-3-18
更新日期:2002-10-14 00:00:00
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pub_type: 杂志文章,多中心研究
doi:10.1186/1471-2296-12-75
更新日期:2011-07-14 00:00:00
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pub_type: 杂志文章,随机对照试验
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更新日期:2014-05-09 00:00:00
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journal_title:BMC family practice
pub_type: 杂志文章
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更新日期:2020-04-23 00:00:00
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journal_title:BMC family practice
pub_type: 杂志文章
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更新日期:2014-06-05 00:00:00
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pub_type: 杂志文章
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更新日期:2015-12-15 00:00:00
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pub_type: 杂志文章
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