Tobacco Treatment Specialist Training for Lung Cancer Screening Providers

Smokers and risk of hospital death by COVID calculated with SAVANA's natural language processing in the Castilla-La Mancha area

INTRODUCTION

During the COVID pandemic, it was speculated that patients with the virus who were smoking-related might have a lower likelihood of disease exacerbation or death. To assess whether there is an association between smoking and risk of in-hospital mortality, SAVANA's big data and Natural Language Processing (NLP) technology is used.

METHOD

A retrospective, observational, non-interventional cohort study was conducted based on real-life data extracted from medical records throughout Castilla La Mancha using Natural Language Processing and Artificial Intelligence techniques developed by SAVANA. The study covered the entire population of this region with Electronic Medical Records in SESCAM presenting with a diagnosis of COVID from March 1, 2020 to February 28, 2021.

RESULTS

Smokers had a significantly higher percentage of cardiovascular risk factors (hypertension, dyslipidemia and diabetes), COPD, asthma, IDP, IC, CVD, PTE, cancer in general and lung cancer in particular, bronchiectasis, heart failure and a history of pneumonia (p < 0.0001).Former smokers, current smokers and non-smokers have a significant age difference. As for in-hospital deaths, they were more frequent in the case of ex-smokers, followed by smokers and then non-smokers (p < 0.0001).

CONCLUSION

There is an increased risk of dying in hospital in SARS-COV2-infected patients who are active smokers or have smoked in the past.

Tobacco treatment specialists' knowledge, attitudes and beliefs about lung cancer screening: Potential piece of the puzzle for increasing lung cancer screening awareness

OBJECTIVES

Less than 5% of eligible U.S. individuals undergo lung cancer screening (LCS). A significant barrier is lack of awareness; more effective outreach and education strategies are needed to achieve greater population LCS uptake. Tobacco Treatment Specialists (TTSs) are an untapped resource to assist and understanding TTS knowledge and perspectives about LCS and readiness and capacity to assist is a critical first step.

METHODS

A sequential explanatory mixed-methods study design was conducted to understand LCS knowledge, attitudes, beliefs, and practices of TTSs. A cross-sectional survey (N = 147) was conducted supplemented with 3 focus groups (N = 12).

RESULTS

TTSs lacked good working knowledge about LCS in general and screening guidelines, but think it is important for their patient population and open to routinely assessing and adding this educational component into their current workflow.

CONCLUSIONS

Tobacco treatment offers a unique venue for LCS awareness and is a setting where there are experienced specialists trained in tobacco use assessment and treatment. Results highlight the unmet training needs required to facilitate integration of tobacco treatment and LCS.

PRACTICE IMPLICATIONS

TTSs are an expanding healthcare workforce. There is a strong need for current TTSs to receive additional training in the benefits of LCS.

Lung cancer screening at the VA: Past, present and future

Lung cancer is responsible for more deaths annually in the United States than breast, prostate and colon cancers combined. Lung cancer screening with annual low-dose computed tomography reduces lung cancer mortality in high-risk patients through early detection. The incidence of lung cancer is higher in the veteran population compared to the general population due, in part, to the prevalence of tobacco use. Early detection of lung cancer is therefore an important goal of the Veterans Health Administration (VHA), the largest integrated health care system in the United States. The following will review previous and current initiatives undertaken by the VHA to implement and expand access to lung cancer screening and will highlight target areas of interest to improve uptake and quality of lung cancer screening. Through these initiatives and programs, the VHA aims to provide high quality and equitable access to lung cancer screening for all Veterans that incorporates research that will improve outcomes and potentially inform and optimize the practice of Lung cancer screening across the United States.

Smoking cessation services and shared decision-making practices among lung cancer screening facilities: A cross-sectional study

BACKGROUND

Little is known about how screening facilities are meeting the requirements for the reimbursement of lung cancer screening from the Centers for Medicare & Medicaid Services (CMS), including 1) the collection and submission of data to the CMS-approved registry (American College of Radiology [ACR] Lung Cancer Screening Registry), 2) the verification of a counseling and shared decision-making (SDM) visit having occurred as part of the written order for lung cancer screening with low-dose computed tomography, and 3) the offering of smoking cessation interventions.

METHODS

The authors identified facilities in a southwestern state that were listed by either the ACR Lung Cancer Screening Registry or the GO2 Foundation Centers of Excellence. To select facilities, they used 2 purposive sampling approaches: maximum variation sampling and snowball sampling. They surveyed facilities from February to November 2019.

RESULTS

There were 87 facilities contacted, and a total of 63 facilities representing 32 counties across Texas completed the survey. Nearly all facilities used Lung-RADS to classify nodules (92%; n = 58) and submitted data to a CMS-approved registry (92%; n = 57). Most facilities verified that the counseling and SDM visit had occurred (86%; n = 54). Although slightly more than half of the facilities reported always providing self-help cessation materials (68%; n = 42), similar or higher proportions of facilities reported that they never referred smokers to onsite cessation services (68%; n = 42) or quitlines (77%; n = 47), provided cessation counseling (81%; n = 50), or recommended medications (85%; n = 52).

CONCLUSIONS

In general, screening facilities are meeting CMS requirements for screening, but they are struggling to offer smoking cessation interventions other than providing self-help materials.

Training Tobacco Treatment Specialists through Virtual Asynchronous Learning

Tobacco dependence is a prevalent, chronic, and complex addiction that often leads to long-term disease and death. However, few healthcare providers are sufficiently trained and feel comfortable in delivering tobacco dependence treatment. The purpose of the study was to examine the effectiveness of an accredited online Tobacco Treatment Specialist (TTS) training program that uses a novel, asynchronous approach. We compared the characteristics of participants who completed the program to those who did not complete the program. Changes in knowledge and attitudes in providing tobacco dependence treatment were measured, and satisfaction with the program and intent to pursue national certification were assessed. Participants who were more likely to complete the program were those who discussed quitting less frequently with patients prior to course enrollment. These participants had a significant increase in knowledge and high satisfaction with the course. Approximately half of participants who completed the program indicated that they would pursue obtaining a national certificate in tobacco dependence treatment in the next 2 years.