• Family medicine · Jun 2016

    Rotation in a Smoking Cessation Clinic Improves Nicotine Dependence Treatment Provided by First-Year Internal Medicine Trainees.

    • Mary M O'Sullivan, Sumedh S Hoskote, Melissa B Lesko, Cristina M Mallozzi, Young I Lee, Oluseyi A Fayanju, Deborah Haller, Muhammad A Rashad, Elvina Khusainova, Diandra Fortune, Roshen Mathew, Chloe Van Tassel, and Ethan D Fried.
    • Department of Medicine, Division of Pulmonary and Critical Care Medicine, Mount Sinai St Luke's and Mount Sinai Roosevelt, New York, NY.
    • Fam Med. 2016 Jun 1; 48 (6): 472-6.

    Background And ObjectivesOver 70% of smokers visit a physician annually, and physicians are well-positioned to assist patients in smoking cessation. Residency offers the ideal setting to train physicians in best practices for treatment of nicotine dependence. We hypothesized that experiential learning during a smoking cessation medical clinic (SCMC) rotation would be associated with an improvement in smoking cessation practice of internal medicine (IM) interns in outpatient primary care and inpatient settings.MethodsThis was a prospective study performed at a large university-affiliated hospital. Forty IM interns rotated through SCMC. After a lecture on nicotine addiction and treatment, interns treated SCMC patients under direct supervision of an attending pulmonologist. Interns' smoking cessation practices before and after SCMC rotation were evaluated through chart review over 1 year. Upon study completion, a survey to assess confidence was administered. Paired t tests measured changes in rates of identifying smokers, offering pharmacological treatment and counseling.ResultsA total of 5,622 outpatient and 683 inpatient charts of interns' encounters with patients were reviewed. Following SCMC rotation, there was an increase in identifying active smokers (7.1% versus 18.7%), prescribing therapy for smoking cessation (6.5% versus 18.0%), and providing counseling (30.9% versus 42.3%) to outpatients. For inpatients, there was an increase in nicotine replacement during admission (12.9% versus 37.4%) and prescription of therapy upon discharge (5.7% versus 16.1%). Interns reported confidence in providing appropriate counseling and treatment.ConclusionsSCMC experience positively impacted smoking cessation treatment by IM interns, causing a measurable change in their practice.

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