PINNACLE Registry Finds Smoking Cessation Assistance Lacking at Cardiology Practices

Only one in three smokers treated at U.S. cardiology practices linked to the PINNACLE Registry receive smoking cessation assistance from the practice despite the documented benefits of cessation. The lack of progress in helping patients stop smoking and the need for improved actions were detailed in a study published in the Journal of the American Heart Association.

Mayank Sardana, MBBS, et al., measured the rates of smoking cessation assistance by examining data from 328,749 smokers treated at 348 cardiology practices enrolled in the PINNACLE Registry. The smokers were treated between Jan. 1, 2013, and March 31, 2016. A high prevalence of cardiovascular factors was present in the smokers, including hypertension in 61 percent, dyslipidemia in 54 percent and diabetes in 20 percent – and nearly one-third had coronary artery disease.

Smoking cessation assistance was documented in 34 percent of patient encounters. Because assessing rates of cessation assistance could be skewed by only measuring recent clinical encounters, the rates of smoking cessation assistance during any clinical encounter during the study period were also measured. Researchers found that cessation assistance was recorded in 34 percent of cardiology-related encounters vs. 33 percent of any clinical encounters. Of the 112,884 encounters in which assistance was documented, cessation pharmacotherapy was prescribed in only 10 percent.

Evaluation of the large variation in providing smoking cessation revealed several factors associated with a lower odds of receiving assistance: older age, diabetes, atrial fibrillation, and practice location in the South Census region and rural or suburban areas.

The authors write that their findings call for immediate action from providers and public health organizations to improve the adherence to providing smoking cessation assistance at outpatient cardiology practices.

"Our findings suggest the presence of a large deficit and largely idiosyncratic provider-level variation in the provision of smoking cessation assistance," researchers conclude. They add, "Our findings form the basis for further investigation into other contributors to smoking cessation assistance, such as economic, social, environmental and organizational factors that could enhance the rates of smoking cessation assistance and reduce variation in care."

Keywords: National Cardiovascular Data Registries, PINNACLE Registry, Registries, Smoking Cessation, Coronary Artery Disease, Atrial Fibrillation, Outpatients, Public Health, Prevalence, Quality Improvement, Censuses, Smoking, Hypertension, Diabetes Mellitus, Dyslipidemias

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