Personalized Patient Alerts and Care Pathways to Prompt Prevention Interventions for Combined Alcohol and Tobacco Users in Primary Care
Tobacco and alcohol use present multiplicative risk for aerodigestive cancers. Reducing
alcohol consumption improves smoking cessation outcomes and reduces cancer risk. Risky
alcohol consumption and smoking are often treated separately despite concurrent treatment
potentially leading to better outcomes for each. However, no rapidly scalable program exists
for combined interventions in primary care clinics spread across wide geographic areas. This
cluster randomized trial aims to report on the effects of a novel clinical decision support
system (CDSS) on intervention rates by primary care practitioners addressing risky alcohol
use in a smoking cessation program.
The investigators will be implementing a clinical decision support system (CDSS) in 221
primary care sites participating in the Smoking Treatment for Ontario Patients (STOP)
program across Ontario, Canada. Sites will be blindly allocated to one of two clinical
decision support systems guiding practitioners to provide a risky alcohol use intervention
to smokers attempting to quit using nicotine replacement therapy (NRT). Risky alcohol use is
defined as drinking above the Canadian Cancer Society's low-risk drinking guidelines.
Primary analysis will measure the proportion of risky drinkers offered an alcohol
intervention in each CDSS arm at baseline. Patients will be contacted by phone or email to
track smoking cessation and alcohol consumption rates at 6- and 12-month follow up.
Upon completion of the trial, the effect of different clinical decision support systems on
practitioner behaviour, and on client tobacco and alcohol use, will be discussed. If the CDSS
successfully promotes SBIRT for risky alcohol use in a primary care setting and/or improves
patient-level outcomes, including smoking cessation rates and alcohol use reduction, this
tool can be used as a model for other web-based behaviour change interventions integrated
into primary care practice.
View this trial on ClinicalTrials.gov
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These resources are provided in partnership with the
Canadian Cancer Society