The Science Journal of the American Association for Respiratory Care

2004 OPEN FORUM Abstracts

IMPACT OF A POINT-OF-CARE CASE MANAGEMENT PROGRAM ON SMOKING HABITS IN A CYSTIC FIBROSIS CENTER.

Reyes JJ, BS RRT-NPS, Hall CR, MS RRT-NPS RPFT, Guill MF, MD. Medical College of Georgia, Augusta, Georgia.

Introduction: Cystic fibrosis patients may be as likely to smoke or be exposed to second-hand smoke as the general population. Any negative impact to their disease process may impact morbidity and mortality. Effective education, to include smoking cessation, may help prevent a decline in pulmonary function and thus may then improve quality of life and outcome in life expectancy.

Methods:
We developed and implemented a point-of-care case management program for patients in our local Cystic Fibrosis Center using a personal data assistant (PDA) and a patient database developed from commercially available software (HanDbaseTM). The case management program was managed by a Respiratory Care Practitioner (RCP) who is the Cystic Fibrosis Educator. Tobacco use or exposure to environmental second-hand smoke data was recorded for future reference on patients zero to 55 years old over a period of 18 months as part of the case management program. All data was available during follow-up visits where the RCP used the PDA to review patient history and current treatment modalities to educate the patient or family members about the importance of smoking cessation or exposure to second-hand smoke. Data was compared for patients or family members who were identified as a smoker (smoker) and were successful at quitting smoking (quitter), actively attempting (attempter), contemplating (contemplator), or not interested (not interested) in quitting smoking.

Results:
A total of 120 patients were involved in the point-of-care management program. Of these, 21% (n=25) were identified as a smoker or family member who smoked. Overall, 84% (n=21) of the patients or family members identified as a smoker either thought about, attempted, or quit smoking after entrance into the case management program. Smoking cessation results after point-of-care education by the RCP during the program are reported in the table below.

Smoker Quitter Attempter Contemplator Not Interested
25 (21%) 5 (20%) 5 (20%) 11 (44%) 4 (16%)

Conclusion: We feel the point-of-care case management program was successful in identifying smokers and those exposed to second-hand smoke in the cystic fibrosis patient population. The data supports that a majority of those identified as a smoker, either as a patient or family member, either quit smoking or wanted to quit smoking after education by the RCP. Thus, implementation of a point-of-care case management program using PDAs may help cystic fibrosis patients improve quality of life and outcome in life expectancy.