The Wisconsin Tobacco Outreach Program

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The Wisconsin TobaccoOutreach Program

• Lezli Redmond, MPH
• Michael Fiore, MD, MPH
• December 2003

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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

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Overview of UW-CTRI
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UW-CTRIs Intervention Programs

• Fulfilling our Promise to Wisconsin
• Ensuring that all Wisconsin residents have ready
  access to evidence-based, affordable cessation
  support.

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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

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The Wisconsin Model
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The Education and Outreach Team
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What is UW-CTRI Outreach?
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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

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Regional Outreach SpecialistsMaking 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

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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

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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

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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

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Clinician Referrals to Quit Line by Quarter
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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

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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

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• www.ctri.wisc.edu