Center for Tobacco Research and Intervention University of Wisconsin Medical School Transdisciplinary Tobacco Use Research Centers The Wisconsin Tobacco Outreach Program Lezli Redmond, MPH Michael Fiore, MD, MPH December 2003

Center for Tobacco Research and Intervention University of Wisconsin Medical School Transdisciplinary Tobacco Use Research Centers Objectives For Today: Describe UW-CTRI Outreach Program structure and purpose Describe our strategies for changing clinical practice Discuss how the Wisconsin Tobacco Quit Line is both a strategy and a resource Give examples of 2003 outcomes

Center for Tobacco Research and Intervention University of Wisconsin Medical School Transdisciplinary Tobacco Use Research Centers Overview of UW-CTRI

Center for Tobacco Research and Intervention University of Wisconsin Medical School Transdisciplinary Tobacco Use Research Centers UW-CTRI’s Intervention Programs Fulfilling our Promise to Wisconsin… Ensuring that all Wisconsin residents have ready access to evidence-based, affordable cessation support.

Center for Tobacco Research and Intervention University of Wisconsin Medical School Transdisciplinary Tobacco Use Research Centers Comprehensive Cessation Program Based on “Best Practices” –US Public Health Services Clinical Practice Guideline: Treating Tobacco Use and Dependence, 2000 –Recommendations of Task Force on Community Preventive Services (2001) Smoking bans Increase price of cigarette products Mass media campaigns Quit lines Healthcare provider reminder systems with provider education Reduce out-of-pocket costs for cessation treatments

Center for Tobacco Research and Intervention University of Wisconsin Medical School Transdisciplinary Tobacco Use Research Centers The Wisconsin Model

Center for Tobacco Research and Intervention University of Wisconsin Medical School Transdisciplinary Tobacco Use Research Centers The Education and Outreach Team

Center for Tobacco Research and Intervention University of Wisconsin Medical School Transdisciplinary Tobacco Use Research Centers What is UW-CTRI Outreach?

Center for Tobacco Research and Intervention University of Wisconsin Medical School Transdisciplinary Tobacco Use Research Centers UW-CTRI Regional Outreach Specialists Changing the way tobacco is treated in Wisconsin –Systems and policy changes are underway in every major health system and HMO in WI Strategies –Academic detailing with follow-up –Community organizing County tobacco control coalitions Many diverse partners and collaboratives Statewide advisory and workgroups

Center for Tobacco Research and Intervention University of Wisconsin Medical School Transdisciplinary Tobacco Use Research Centers Regional Outreach Specialists Making It Easy… Teach providers brief intervention (3 minutes) for smoking (free CMEs, CEs, CEUs and specialized training) Provide free materials, evidence, and other tools Deliver individualized training and technical assistance (models, etc.) for systems changes Facilitate use of state-funded Quit Line for treatment and follow-up services

Center for Tobacco Research and Intervention University of Wisconsin Medical School Transdisciplinary Tobacco Use Research Centers Working With Systems (Dean, Marshfield, Aurora) Insurers Clinics/Hospitals Community Groups, Worksite, AODA, etc... All Healthcare Providers -Doctor-Nurse Practitioner -Nurse-Physician Assistant -Medical Assistant -Clinic Manager -Dental Health Provider -QI Manager

Center for Tobacco Research and Intervention University of Wisconsin Medical School Transdisciplinary Tobacco Use Research Centers UW-CTRI Training Resources Continuing Medical Education/Continuing Education Units Pharmacotherapy Video Counseling Techniques Video Clinical Packet and Hospital Packet Statewide and regional workshops (“Practical Strategies”) featuring UW-CTRI scientists and other national experts Access to cutting-edge research

Center for Tobacco Research and Intervention University of Wisconsin Medical School Transdisciplinary Tobacco Use Research Centers

Center for Tobacco Research and Intervention University of Wisconsin Medical School Transdisciplinary Tobacco Use Research Centers Fax To Quit Program Gives tobacco users the option of having a Quit Line counselor contact him/her to provide an individualized intervention Potential to integrate Quit Line services into all hospitals, clinics, worksites, and agencies Over 165 sites on board; many in the works

Center for Tobacco Research and Intervention University of Wisconsin Medical School Transdisciplinary Tobacco Use Research Centers Clinician Referrals to Quit Line by Quarter

Center for Tobacco Research and Intervention University of Wisconsin Medical School Transdisciplinary Tobacco Use Research Centers Activities and Impact We have made 850 visits with clinics, hospitals and healthcare delivery systems Trained over 10,000 clinicians in brief intervention Delivered CME training to 863 clinicians and 600 more on-line Partnered with 23 “free clinics” to provide NRT and counseling services to 500 uninsured patients

Center for Tobacco Research and Intervention University of Wisconsin Medical School Transdisciplinary Tobacco Use Research Centers Activities and Impact Results? Increases in insurance coverage for treatment Increases in referrals to the Quit Line Increases in heathcare delivery systems changes Improved access to cessation treatments

Center for Tobacco Research and Intervention University of Wisconsin Medical School Transdisciplinary Tobacco Use Research Centers