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Implementation of evidence-based tobacco use cessation guidelines in managed care organizations
Journal article   Open access   Peer reviewed

Implementation of evidence-based tobacco use cessation guidelines in managed care organizations

C Barr Taylor and Susan J Curry
Annals of behavioral medicine, Vol.27(1), pp.13-21
02/01/2004
DOI: 10.1207/s15324796abm2701_3
PMID: 14979859
url
https://doi.org/10.1207/s15324796abm2701_3View
Published (Version of record) Open Access

Abstract

BACKGROUNDAlthough managed care organizations (MCOs) may be optimal settings for implementing tobacco use cessation clinical guidelines, such guidelines remain poorly implemented in many MCO settings.PURPOSEWe examined issues related to the implementation of guidelines in MCOs, to provide examples of studies that have addressed issues related to guideline implementation and to suggest ways behavioral medicine researchers can play a role in examining issues of how guidelines can be better implemented.METHODSSurveys of clinical guideline implementation, studies from the Robert Wood Johnson Foundation addressing tobacco use cessation in a managed care database, selected to illustrate issues related to system-wide implementation.RESULTSSurveys show that effective tobacco use cessation interventions remain underutilized in MCOs. A few studies have evaluated and shown the benefit of insurance coverage for tobacco use and dependence treatments, clinician reimbursement and leadership incentives, practice feedback, and leveraging administrative data to create tobacco use tracking systems. The studies also point to the need for large-scale, multidisciplinary, methodologically rigorous studies that allow one to isolate the effects of promising strategies as well as to explore synergistic effects as different system changes are combined.CONCLUSIONSTobacco use cessation guidelines need to be better implemented in MCOs. Behavioral medicine research needs to move beyond treatment efficacy and effectiveness studies to focus on rigorous evaluations of these and other strategies to enhance guideline implementation and dissemination.

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