The Allina Medical Clinic, a large multispecialty group practice, evaluated how to implement the U.S. Agency for Health Care Policy and Research (AHCPR) Smoking Cessation Guideline.

A team of researchers from the University of Wisconsin's Center for Tobacco Research and Intervention helped Allina to conduct a group randomized trial to determine the effectiveness of a smoking cessation strategy based on the ACHPR guideline.

The researchers planned to compare six-month quit rates between smokers in intervention and control clinics, assess how the guidelines were implemented at the clinic level, and tabulate the total cost of guideline implementation as well as the cost per smoker.

Key Findings

• Through patient exit interviews, researchers discovered that patients in intervention clinics were only marginally more likely to be asked if they smoked and about as likely to receive advice to quit smoking as those in control clinics.
• No significant differences in quit rates between intervention and control clinics were detected.
• The researchers concluded that the implementation strategy lacked a key component: a performance-based physician incentive plan to promote compliance with the guidelines.

After the Grant

Based on the groundwork established under this project, Allina Health System received a $500,000 grant (ID# 036023) from the Robert Wood Johnson Foundation's (RWJF) national program, Addressing Tobacco in Managed Care. Under this grant, Allina will incorporate physician incentives, performance expectations and a patient follow-up system into its group practice.

Funding

RWJF provided a $48,171 grant to support this project.