Preety Kalra, MS¹, Scott Sherman, MD, MPH², Nancy Takahashi, MPH³, Elizabeth Gifford, PhD¹, Ware Kuschner, MD⁴, James Canfield⁵, John Kelly, PhD⁶, and John Finney, PhD¹. (1) Center for Health Care Evaluation, VA Palo Alto Health Care System/Stanford University School of Medicine, 795 Willow Road (152), Menlo Park, CA 94025, 650-493-5000 x29834, Preety.Kalra@med.va.gov, (2) Associate Professor 0f Medicine, UCLA School of Medicine/VA Greater Los Angeles Health System, 16111 Plummer Street, North Hills, CA 91343, (3) VA Greater Los Angeles Health Care System, 16111 Plummer Street, North Hills, CA 91343, (4) Assistant Professor of Medicine, VA Palo Alto Health Care System/Stanford University School of Medicine, 3801 Miranda Avenue, Mail Stop 111P, Palo Alto, CA 94304, (5) VA Palo Alto Health Care System, 3801 Miranda Avenue, Mail Stop 111P, Palo Alto, CA 94304, (6) Bio Med Alcohol & Addiction, Brown University, Box G-BH, Providence, RI 02912

Objectives: Despite widespread availability of free smoking cessation Quitlines and scarce resources, few health care organizations refer patients to Quitlines. We tested the effectiveness of a telephone care coordination program that provided biweekly follow-up calls for eight weeks to increase referrals to the California Smokers’ Helpline and dispense smoking cessation medications.

Methods: Ten sites at VA Medical Centers and community-based clinics in Northern and Southern California received the intervention for a 10-month period. These sites had access to an electronic clinical reminder for referrals into the program, Post-It reminders for nurses to alert physicians of patients’ smoking status, educational brochures on the program, monthly contact with program staff, and feedback on site performance and patient participation.

Results: At baseline, providers reported that they essentially never referred patients for telephone counseling. During the first eight months, the Telephone Smoking Cessation Program received 2,713 referrals. Of those, 1398 (52%) were contacted. Of the patients contacted 1044 (75%) agreed to counseling from the state quitline and enrolled in the program. Of the patients who enrolled, 938 patients (90%) completed the 30-minute counseling from the state quitline.

We were unable to reach 799 patients (29%) despite multiple attempts, 177 (7%) patients were ineligible for enrollment, 339 patients (13%) are in process.

Conclusions: The 8-week Telephone Smoking Cessation Program dramatically increased use of the state Quitline and to date 23% have successfully completed the 2-month program. This program increases access to smoking cessation treatment without overwhelming primary care providers.

Learning Objectives: At the conclusion of the session, the participant in this session will be able to

• Describe a managed care system's approach to tobacco cessation.
• Evaluate use of quitlines in aiding tobacco cessation efforts.
• List components of a telephone care coordination system for tobacco cessation.

Keywords: Smoking Cessation, Health Care Managed Care

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.