Local Healthcare Providers Use National Guidelines

Residents of Gulf County can rest assured that local health care providers are doing everything possible to give the best care available.

In a recent survey of all the county healthcare providers, including specialists who provide services through The Gulf County Health Department, all providers report routinely using the Centers for Disease Control and Prevention (CDC) best clinical practices and the U.S. Public Health Service’s (PHS) guidelines.

The health department’s Tobacco Prevention Program conducted the survey to see how many local healthcare providers were incorporating both CDC best practices and PHS guidelines for tobacco prevention and cessation in their daily patient care visits. These guidelines offer the best information and actual clinical practices available for health practitioners to use in office visits.

The Tobacco Prevention Program was interested in discovering if local healthcare providers were asking about tobacco use with each patient, on every visit, and knew of the resources available to patients for cessation services and guidelines for helping them quit using tobacco products.

All of Gulf County’s healthcare providers reported that they routinely use the guidelines in an effort to help reduce the number of local patients who use tobacco, either cigarettes or smokeless.

Do you smoke? Do you want to quit? These two questions should be among the first things a healthcare provider asks each patient every time he or she sees that patient in the clinical setting.

Whatever the answers, clinicians who use CDC best practices and PHS guidelines are aware – and use – all the recommendations, treatment options and support for both themselves and patients that are available in the fight to stop tobacco use.

The latest PHS Guideline is “Treating Tobacco Use and Dependence: 2008 Update.” The recommendations are designed particularly for clinical settings (healthcare visits) and the update was written for all tobacco users, not just those who smoke cigarettes.

The considerably expanded research that has been discovered since the original 2000 guideline is incorporated in the update, and shows even stronger evidence that counseling is an effective strategy in treating tobacco use.

It notes particularly that individual patient counseling by the healthcare provider at every visit adds significantly to the effectiveness of tobacco cessation medications; that quitline counseling is an effective intervention with a broad reach; and that counseling increases abstinence from smoking among youth who already smoke.

The updated guideline offers clinicians more medications to use for smoking cessation than before, and provides information about their effectiveness relative to each another.

It also gives clinicians 10 key guidelines dealing specifically with clinical approaches for every patient and dealing with the different patient attitudes toward their smoking habits.

As part of the states’ tobacco grant programs, administrators of the Florida tobacco grant are pushing for CDC best practices to be used in all health care organizations in the state.

Proponents of the best practices program want every Florida healthcare organization to adhere to the same practices, including extensive patient/provider education on the risks of smoking, methods of cessation, and help with related issues like secondhand smoke.

One method of incorporating best practices into every day clinical activity is to use a health history form that documents patient information about his or her smoking habits.

The form is completed by all patients and reviewed by the healthcare provider. Patient education is then offered for specific tobacco-related issues like elimination of second-hand smoke in the home environment; preventing people from starting to use tobacco; interventions and cessation help like the Florida Quitline or counseling; and prescribing medications, where applicable, to augment cessation efforts.

Implementing best practices does require education on the part of the providers and staff, as well. Such efforts can be reinforced during provider and staff meetings, as continuing education.

The benefits to a healthcare facility that uses CDC best practices on a regular basis can be enormous.

According to one local provider who uses the practices daily, just using practices on tobacco issues offers benefits like improving the health status of patients who do smoke, and possible preventing a non-smoker from ever starting to smoke, just through education.

Patients at a clinic that uses best practices gain more information about the effects of smoking on their health, and they are given information or tools to enable them to actively participate in improving their own health outcome. That makes patients who take ownership in the course of their disease or illness more compliant with treatment measures, she said.

Centers that do not use best practices as it pertains to tobacco issues do not use the patient’s health history form as a screening tool, and do not routinely ensure that patients are receiving education and information about smoking prevention or cessation. That means the healthcare providers are not involving their patients in improving their own health status, and are missing multiple opportunities to treat an underlying cause of many major illnesses.