Call it Quits Referral Program

The Call it Quits Referral Program is a project of the Call it Quits Collaborative, administered by the Minnesota Department of Health

Agenda • Why should we do this? • What is the Referral Program? • Clinical Practice Guidelines: The “5 A’s” • How does it work? • Patient experience • Reporting • The successful clinic

Why? of smokers see a physician each year of smokers report wanting to quit

AND Smokers cite a physician’s advice to quit as an important motivator for attempting to stop smoking

Source: Fiore MC, Jaén CR, Baker TB, et al. Treating Tobacco Use and Dependence: 2008 Update. Clinical Practice Guideline. Rockville, MD: U.S. Department of Health and Human Services. Public Health Service. May 2008.

What is it? The Call it Quits Referral Program: • allows providers to easily refer patients to tobacco cessation phone counseling services via a single fax referral form • launched statewide in October, 2007 • is supported by a collaboration of Minnesota’s major health plans and ClearWay Minnesota • has over 1100 clinics registered to date (medical, dental, public & behavioral health) • has a 27% overall enrollment rate • is FREE to all Minnesotans!

Why Phone Counseling? • •

Statistics show that fewer than 1 in 20 smokers will be successful in quitting tobacco and staying quit.1 With tailored phone-based coaching, greater than 1 in 3 will be successful in quitting and staying quit.2

1 According

to ACS, only about 4% to 7% of people are able top quit smoking on any given attempt without medicines or other help. Studies in medical hournals have reported that between about 25% and 33% of smokers who use medicines can stay smoke-free for over 6 months. 2 Alere Wellbeing performance metrics for Blue Cross and Blue Shield of Minnesota, 2013. 45% quit rate based on a 30 day quit rate at a 6 month follow-up.

Clinical practice guidelines The 5 A’s ASK ADVISE ASSESS ASSIST ARRANGE

#1- ASK about tobacco use

…and document

#2 - ADVISE to quit “The most important thing you can do to improve your health is to quit smoking, and I can help you.”

#3 - ASSESS willingness to quit “Are you willing to try to quit at this time? I can help you.”

#4 - ASSIST in quit attempt “Interventions lasting just three minutes increase overall tobacco abstinence rates.” U.S. Department of Health and Human Services, “Treating Tobacco Use and Dependence, 2008 Update”

Quitline services: - Free - Confidential - Effective - Available regardless of insurance coverage

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#5 - ARRANGE for follow-up

How the program works 1

Provider assesses tobacco status & asks if patient is interested in quitting

2

Patient fills out referral form, or staff create EMR order for smoking cessation and obtain verbal consent

3 Designated staff fax referral/EMR to central triage

5

Result of patient outreach faxed back to provider

4

Quitline contacts patient

Services for Minnesota Provider Fax

Referral faxed to single triage number

Call it Quits Referral Triage

Health Plan 1

Quitline A

Health Plan 2

Health Plan 3

Quitline B

Etc.

Quitline C

No Plan or Program

QUITPLAN Services

Call it Quits Referral Triage sorts referral based on health plan check box Referral faxed to appropriate quitline

Referral Form Site Information (pre-populated)

Patient Information

Quitline Outcome

Downloadable Materials • Provider is sent personalized referral form and patient takeaways • Provider downloads additional materials as desired

Patient experience: components • A series of individually tailored calls from a quitline coach • Unlimited inbound calls to a quitline coach • Program materials mailed to each participant • Prescription consultation • Over-the-counter (OTC) fulfillment available via direct mail to enrolled participants* *costs vary depending on the individual’s benefit coverage

Patient experience: first call • The quitline will: – confirm contact info – determine the patient’s tobacco history and readiness to quit – describe the program and number of scheduled phone calls the patient can expect – explain how to access the support line – answer quit medication questions (quit coach cannot prescribe)

• The patient will accept or decline enrollment

More for Less Clinic Intervention • 5-10 Minutes – Ask – Advise – Brief Counseling

Call it Quits Referral • 3-6 Minutes – Ask – Advise – Assess & Assist (CiQ Referral) • 4-5 calls • Free counseling

• 7 - 10% Quit

• 15 - 40% Quit

Reporting Online reporting is available through a third-party vendor, Professional Data Analysts (PDA). • https://www.pdastats.com/CallitQuitsReports/login.aspx • User name and password required

Sample report

The successful clinic • Champion – Resource – Promoter – Training new staff

• Process • Feedback • Realistic expectations

We can do it!

How it works… Thank you Together we’ll make it easier for your patients to take the next step toward becoming tobacco free. E-mail: [email protected] More information: www.health.mn.gov/callitquits