Christin D’Ovidio JSI Research and Training Institute, Inc. 6/23/2018 10:19 PM Tobacco Treatment Quitlines are telephone-based services that offer counseling and information to help smokers quit. In 1992 research completed by a panel of health system experts demonstrated that telephone-based counseling for cessation is an effective treatment. California Health Department launched the first statewide telephone counseling services to help smokers quit. The North American Quitline Consortium is a non-profit organization that unites quitline stakeholders, funders, service providers, researchers and national organizations in US and Canada to maximize access, use and effectiveness of North American quitlines through forums, conducting research and providing leadership and a unified voice to promote quitlines as a valuable healthcare community resource. Funding is an important issue around quitline sustainability because the reach and scope of services a quitline provides is directly related to funding. Christin D’Ovidio JSI Research and Training Institute, Inc. © 2007 Microsoft Corporation. All rights reserved. Microsoft, Windows, Windows Vista and other product names are or may be registered trademarks and/or trademarks in the U.S. and/or other countries. The information herein is for informational purposes only and represents the current view of Microsoft Corporation as of the date of this presentation. Because Microsoft must respond to changing market conditions, it should not be interpreted to be a commitment on the part of Microsoft, and Microsoft cannot guarantee the accuracy of any information provided after the date of this presentation. MICROSOFT MAKES NO WARRANTIES, EXPRESS, IMPLIED OR STATUTORY, AS TO THE INFORMATION IN THIS PRESENTATION. 1

Objectives for this Webinar Participants will: Understand 1-800-QUIT-NOW quitline tobacco treatment services Understand QuitWorks-NH clinical referral resource to tobacco treatment services Based on the 2012 response of 37 states to the NAQC annual survey, 34 (92%) receive their funding from CDC, 17 (less than ½) receive MSA funding, 5 receive Federal financial participation (FFP) for quitline administrative expenditures for Medicaid beneficiaries 7 receive State/provincial dedicated tobacco tax funds 7 receive State/provincial general funds 24 have cost-sharing agreement in progress or are operational at level

Do you know… What % of your patient population uses tobacco? What % of the patient population has been referred for tobacco treatment? What was the outcome of that treatment was? What is the quit rate among patient population?

Treating Tobacco Use and Dependence 6,000 research articles Dose-response Multiple medications Counseling Quitlines are effective NH was funded, Year 1 funds went directly to enhancing the Helpline’s capacity and Year 2 was released as the Partnerships for Sustainability RFP. To promote improved health plan coverage for tobacco cessation. Achieve partnerships for financial support of the Helpline. Scope of the contract Carry out 3 phases of work relative to engaging health plan stakeholders to share the cost of Helpline services to their members. Document research and activities.

Tobacco Use is a Chronic Disease Today’s tobacco products contain higher amounts of nicotine More addictive Results in current medications losing effectiveness Self-medication with nicotine to cope with underlying mental health conditions Practitioners advice makes a difference Requires repeated interventions- Motivational Interview skills are critical Remains on the Problem List

Evidence of Effectiveness Advice Research Arms Estimated odds ratio (99% C.I.) Estimated Abstinence Rate (99% C.I.) No advice to quit 9 1.0 7.9 Physician advice to quit 10 1.3 (1.1 – 1.6) 10.2 (8.5 – 12.0)

Ask, Assist and Refer for Treatment Common practice within Concord Hospital and affiliated offices EHR vendor flexibility ICD 10 codes for tobacco use/dependence Electronic referral protocol to any medical specialty group http://www.icd10data.com/ICD10CM/Codes/F01-F99/F10-F19/F17-

What is Meaningful Advise? Stage of readiness is critical Meet the patient where they are Message care, compassion and support Ask THEM what they want

Self-Referral 1-800-QUIT-NOW (1-800-784-8669) “You have reached…” “Press 1 for English” “How may I help you?” www.QuitNowNH.org On-line Enrollment June 2017 On-line Quit Coaching!!

QuitWorks-NH.org is HIPPA compliant: Paper fax Electronic fax eReferral using C-CCD Contact Teresa Brown BS, TTS at NH Tobacco Prevention and Cessation Program Division of Public Health Services Teresa.Brown@dhhs.nh.gov 603-271-8949

What Professionals Need to Know Referrals to QuitWorks-NH are received at National Jewish Health Hospital’s Call Center for Integrated Health-Denver Colorado Over 100 trained Quit Coaches Out reach calls are within 24 hours (1-800-784-8669) 3 calls in 3 days-they leave messages Feedback reports sent to the referring professional

What Patients Need to Know Out reach calls show up as 1-800-784-8669 Auto-dialed then connected to Intake Specialist Split-second lag time with a ‘click’ before Intake Specialist says anything 5 Minute Intake Screener must be completed before transferred to a Quit Coach There is a 30 second HOLD to connect to a Quit Coach

Quality Improvement Project Choose a Hospital Unit or Office Practice Assess patient population for tobacco use Assess co-morbidity among this population Assess current workflow for treating these patients Insert Quit Now NH into the workflow based on training and technical assistance from NH Tobacco Prevention and Cessation Program Plan Do Study Act cycles

Resources https://www.bhwellness.org/resources/videos/conversations-for-change-series www.cdc.gov/tobacco www.QuitNowNH.org www.QuitWorksNH.org www.ATTUD.org

Teresa Brown 603-271-8949 tmbrown@dhhs.nh.gov