| Titre : | National patterns in the treatment of smokers by physicians. (1998) |
| Auteurs : | A.N. THORNDIKE ; N.A. RIGOTTI ; D.E. SINGER ; R.S. STAFFORD ; Department of Medicine. Harvard Medical School. Boston Mass. USA ; Medical Services. Massachusetts General Hospital. General Medicine Division. Boston Mass. USA |
| Type de document : | Article |
| Dans : | JAMA - Journal of the american medical association (vol. 279, n° 8, 1998) |
| Pagination : | 604-608 |
| Langues: | Anglais |
| Mots-clés : | Tabagisme ; Thérapeutique ; Relation médecin malade ; Prévention santé ; Etats Unis ; Amérique du Nord ; Amérique ; Homme ; Toxicologie ; Santé mentale ; Education santé |
| Résumé : | [BDSP. Notice produite par INIST C31R0xN0. Diffusion soumise à autorisation]. Context. - Routine treatment of smokers by physicians is a national health objective for the year 2000, a quality measure for health care plans, and the subject of evidence-based clinical guidelines. There are few national data on how physicians'practices compare with these standards. Objective. - To assess recent trends in the treatment of smokers by US physicians in ambulatory care and to determine whether physicians'practices meet current standards. Design. - Analysis of 1991-1995 data from the National Ambulatory Medical Care Survey, an annual survey of a random sample of US office-based physicians. Setting. - Physicians'offices. Patients. - A total of 3254 physicians recorded data on 145716 adult patient visits. Main Outcome Measures. - The proportion of visits at which physicians (1) identified a patient's smoking status, (2) counseled a smoker to quit, and (3) used nicotine replacement therapy. Results. - Smoking counseling by physicians increased from 16% of smokers'visits in 1991 to 29% in 1993 (P<. 001) and then decreased to 21% of smokers'visits in 1995 (P<. 001). Nicotine replacement therapy use followed a similar pattern, increasing from 0.4% of smokers'visits in 1991 to 2.2% in 1993 (P<. 001) and decreasing to 1.3% of smokers'visits in 1995 (P=007). Physicians identified patients'smoking status at 67% of all visits in 1991 ; this proportion did not increase over time. (...) |
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