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June 12, 2009 — Smokers who have tried to kick their habit may have used gum, patches or even the "cold turkey" method but probably not a computer.
It may seem unusual but Dr. Scott Strayer, physician and researcher in the Department of Family Medicine at the University of Virginia Health System, thinks it can help. He received $1.3 million from the National Institute on Drug Abuse, part of the National Institutes of Health, to further develop and evaluate an online smoking cessation tool that puts information and counseling techniques in the hands of primary care physicians – literally.
The three-year study will evaluate QuitAdvisorMD, an application for use on handheld computers that doctors can use during routine office visits to help patients quit smoking.
"Most people are aware of the health hazards associated with smoking," Strayer said. "The QuitAdvisorMD tool to be developed with this funding is based on principles of Motivational interviewing, which has been shown to increase the likelihood of future quit attempts, even though a person may not be ready at that particular visit."
Motivational interviewing – or MI – is best described as a patient-centered counseling style that helps the subject work through their conflicting feelings about an issue. In this case, it is a desire to quit smoking while simultaneously craving that next cigarette. Since patients are seen in primary care settings more often than any other sector of the U.S. health care system, primary care physicians are well positioned to provide this smoking cessation support with QuitAdvisorMD.
"When physicians use this tool, we have shown that they become more confident in counseling their patients about smoking cessation and are more likely to complete all the necessary steps in helping patients with a successful quit attempt," Strayer said.
Silverchair, Inc., a communications and technology firm in Charlottesville, developed a prototype of QuitAdvisorMD. It was tested for usability among primary care physicians. During interviews with simulated patients in a live clinical setting, the volunteer physicians were able to use the device in a realistic amount of time. They also found QuitAdvisorMD clear and understandable.
"We are extremely pleased that the National Institute on Drug Abuse's support will help us continue to address the difficult problem of smoking cessation, and we look forward to continuing our partnership with U.Va.'s Department of Family Medicine," said George Reynolds, Silverchair's vice president of health information research and the project's principal investigator.
Strayer noted, "Smoking is still the leading cause of preventable disease and death in the United States and costs the U.S. over $150 billion each year in health care costs. Equipping health professionals with proven, effective interventional tools will greatly help the 45 million adults who are still smoking."
With this new grant, additional modifications for usability can be made. In addition, researchers can learn whether use of the handheld device influences smoking cessation among smokers.
"Smoking cessation can be looked at in terms of several levels of prevention," Strayer said. "In primary prevention, you are actually attempting to keep people from starting to smoke.
"However, if a patient has started smoking, secondary prevention looks at assisting them with stopping before they develop complications such as heart attacks, strokes or lung disease," he added. "QuitAdvisorMD can definitely help with that aspect of prevention, as well as with tertiary prevention, where a patient may have already suffered from a heart attack, stroke, or has lung disease, but assisting them with quitting can decrease the risks of further morbidity and mortality."
According to Strayer, QuitAdvisorMD also will send follow-up messages to patients via e-mail, personalized Web pages and cell phone text messages. Physicians can access QuitAdvisorMD as part of the CEASE smoking initiative and get a free version of the current tool by visiting http://www.ceasesmoking2day.com/.
Founded in 1993, Silverchair Science+Communications, Inc. delivers information services to scientific, technical and medical professionals through advanced technology and publishing solutions. It maintains offices