Cessation pathways: Creating Community-Clinical Linkages to Treatment - PowerPoint Presentation

Slide1

Cessation pathways:

Creating Community-Clinical Linkages to TreatmentSlide2

Session ObjectivesHighlight the burden of tobacco use in ColoradoReview Colorado QuitLine program fundamentals, including access, eligibility and service deliveryUnderstand the critical role of providers on impacting quit attempts and cessation

successSlide3

Colorado Data StoryIn 2016, nearly 68% of smokers attempted to quitAmong smokers who saw a health provider in the past year, advice to quit increased from

68.0% to

76.9%

and

referral to cessation treatment increased from 38.6% to 51.1%.

Smokers who are advised to quit attempt quitting at higher ratesSlide4

Colorado Data StorySlide5

Statement on Structural Inequity The Colorado Department of Public Health and Environment acknowledges that social, economic and environmental inequities result in adverse health outcomes and have a greater impact than individual choices. Reducing health disparities through systems change can help improve opportunities for all Coloradans.Slide6

Disparities SnapshotLow SESUninsured and Medicaid membersAdults <65 yearsNative American & BlackLGBT

Unemployed & unable to work

Persons with behavioral health

conditions

Pregnant women

Access VISION: www.colorado.gov/pacific/cdphe/vision-data-toolSlide7

Disparities: LSESData Source: Behavioral Risk Factor Surveillance System (BRFSS) Slide8

Disparities: InsuranceData Source: Behavioral Risk Factor Surveillance System (BRFSS) Slide9

Disparities: Mental HealthData Source: Behavioral Risk Factor Surveillance Survey (BRFSS) Slide10

Disparities: Cessation SuccessData Source: The Attitudes & Behaviors Survey (TABS) Slide11

Portrait of a Current SmokerLess likely to have a regular providerLess likely to have annual wellness visit and be up-to-date on preventive servicesLess likely to meet nutrition and physical activity recommendationsMore likely to be diagnosed with COPD, arthritis, cancer, cardiovascular disease, and depressionLikely to have attempted to quit smoking in the past yearSlide12

The Impact of Provider AdviceCompared to people who smoke who do not get help from a clinician, those who get help are 1.7–2.2 times as likely to successfully quit for 5 or more months1.

1

Fiore

et al. (2008). Treating Tobacco Use and Dependence: 2008 Update.Slide13

Tobacco Use Standard of CareAll patients should be ask

ed if they use tobacco and should have their tobacco use status documented on a regular basis

All physicians should strongly

advise

every patient who smokes to quit because evidence shows that physician advice to quit smoking increases abstinence ratesEvery tobacco user should be offered at least a minimal intervention and referral to evidence-based treatment, such as the Colorado

QuitLineSlide14

QuitLineService Delivery Basics This section will highlight current QuitLine benefits and accessibility options for Colorado residents. Slide15

Why QuitLine? Quality QL

can provide the treatment intensity that often cannot be

offered

in a clinical setting due to time

constraintsCoordination

QL works in conjunction with physician intervention and provides feedback on client progress

Access

QL increases access &

reduces barriers, including those related to: cost, travel, language & business

hours Slide16

QuitLine: At a GlanceHow To Reach Us1-800-QUIT-NOW1-800-652-3455 (CO direct)

1-855-DEJELO-YA

1-800-659-2656 (TTS)

www.coquitline.org

Features

Intensive

, client-centered coachingConfidential

Non-judgmental

Free NRT

Self-help materials

Text-messaging and email supportSlide17

To enroll, caller must be:a Colorado Resident15 years of age for the coaching program18 years of age to receive cessation medication*Insurance status and nicotine dependence levels are not eligibility criteria

*Provider consent is required for individuals self-reporting uncontrolled hypertension, heart attack or stroke occurrence within the past calendar year; and for pregnant and breastfeeding women

EligibilitySlide18

Participants can enroll byPhone (1-800-QUIT-NOW)Provider Referral (fax, web or e-referral)Online (COQuitLine.org)www.coquitline.org

7 day per week, Multilingual Call Center

5 am to 11 pm MST

Voicemail available 24 hours

5 Call Program

Up to 5 Coaching Calls (Outbound at scheduled times)Unlimited inbound calls for support

Access & EnrollmentSlide19

Referral ProgramQuitLine receives

referral

Patient receives call from QL within 48

hours

Up to 3 attempts

are made to reach client over a 10 day period Fax back to HIPAA covered provider:

When referral is receivedWhen patient enrolls, is unreachable or declines When patient receives NRT

When patient completes the

programSlide20

Every CO participant (18 or older) enrolled in coaching is eligible for 2 quit attempts and 2 courses of nicotine replacement therapy (NRT) or 1 course of Chantix per 12 months*

Products shipped direct to client’s residence

Clients

must maintain enrollment in the coaching program

to receive additional medication

shipments

*A client's calendar year begins on the date of their first QuitLine

medication order.

Pharmacotherapy

BenefitSlide21

NRT OptionsMonotherapyPatch, gum, or lozenge offered (one product)Course of therapy delivered in two, four week shipments

Combination Therapy

6

weeks of patch

plus short acting NRT (gum or lozenge) and one additional 2 week course of

monotherapy (client choice of product). Slide22

Chantix® (varenicline) Benefit Standard course of TherapyClients are eligible to receive one* 12 week course annuallyProvider prescription is required and faxed direct to Ridgeway mail order pharmacy

*

For clients who cannot tolerate

Chantix

, or who choose to discontinue the product after one month, a full 8 week course of NRT may be offered as a replacement to support the first quit attempt. Slide23

Chantix® (varenicline) Process FlowSlide24

Ridgeway Pharmacy Accepts prescriptions via fax, e-script and mailLicensed to sell prescriptions in all 50 states2824 US Hwy 93 NorthVictor, MT 59875Phone: 1-800-630-3214Fax: 406-642-6050

https

://ridgeway.pharmacy/ Slide25

Digital PromotionSlide26

Colorado MedicaidAll FDA-approved cessation medications are covered* at low or no cost for up to two 90 day courses of treatment*Prior Authorization and cessation counseling requiredIndividual and group behavioral counseling are offered by qualified providers at no costSlide27

ContactMichelle LynchCessation and Health Systems Supervisor, CDPHE303.692.2519michelle.lynch@state.co.us

Thanks

for all you do to support tobacco cessation in Colorado.