TY - JOUR
KW - Diabetes
KW - serious mental illness
KW - Smoking Cessation
AU - A. R. Hwong
AU - J. Schmittdiel
AU - D. Schillinger
AU - J. W. Newcomer
AU - S. Essock
AU - Z. Zhu
AU - W. Dyer
AU - K. C. Young-Wolff
AU - C. Mangurian
A1 - 
AB - INTRODUCTION: Smoking is a significant modifiable risk factor for mortality for persons with serious mental illness (SMI), who have a life expectancy 15-20 years shorter than the general population. Individuals with SMI and comorbid diabetes who are smokers face an even higher risk of cardiovascular complications and early death. Yet despite high rates of smoking among people with SMI, tobacco cessation interventions have not been broadly offered to this population. METHODS: We conducted a retrospective cohort study using electronic health records from 2014 in a large integrated care delivery system to examine whether use of smoking cessation pharmacotherapy among smokers with type 2 diabetes varies by serious mental illness (SMI) diagnosis. We analyzed smoking cessation medication prescription fills among adult smokers with diabetes, comparing those with SMI (N = 634) and without SMI (N = 18,021). Risk ratios were adjusted for age, gender, race, urban area type, and medical facility. RESULTS: Of the SMI group, 19.09% filled at least one smoking cessation prescription compared to 9.73% of the non-SMI group (adjusted risk ratio 1.80 [95% CI 1.52-2.13]; p < .001). For the SMI group, primary care providers wrote 80.24% of prescriptions, while psychiatrists wrote 8.81% of prescriptions. CONCLUSIONS: These findings offer an example of a delivery system with higher uptake of smoking cessation pharmacotherapy among people with SMI than without SMI, and highlight the opportunity to provide more smoking cessation interventions in mental health care settings.
AD - University of California, San Francisco, Weill Institute of Neurosciences, Department of Psychiatry, USA. Electronic address: Alison.Hwong@ucsf.edu.; Kaiser Permanente Northern California Division of Research, Oakland, CA, USA.; UCSF Center for Vulnerable Populations at Zuckerberg San Francisco General Hospital, USA; UCSF Division of General Internal Medicine at Zuckerberg San Francisco General Hospital, USA.; Thriving Mind South Florida, Miami, FL, USA; Washington University School of Medicine, Department of Psychiatry, St. Louis, MO, USA.; Columbia University, Department of Psychiatry, USA.; Kaiser Permanente Northern California Division of Research, Oakland, CA, USA.; Kaiser Permanente Northern California Division of Research, Oakland, CA, USA.; University of California, San Francisco, Weill Institute of Neurosciences, Department of Psychiatry, USA; Kaiser Permanente Northern California Division of Research, Oakland, CA, USA.; University of California, San Francisco, Weill Institute of Neurosciences, Department of Psychiatry, USA; UCSF Center for Vulnerable Populations at Zuckerberg San Francisco General Hospital, USA; UCSF Philip R. Lee Institute for Health Policy Studies, USA.
BT - Addictive Behaviors
C5 - Healthcare Disparities
CY - England
DO - 10.1016/j.addbeh.2020.106697
JF - Addictive Behaviors
LA - eng
M1 - Journal Article
N2 - INTRODUCTION: Smoking is a significant modifiable risk factor for mortality for persons with serious mental illness (SMI), who have a life expectancy 15-20 years shorter than the general population. Individuals with SMI and comorbid diabetes who are smokers face an even higher risk of cardiovascular complications and early death. Yet despite high rates of smoking among people with SMI, tobacco cessation interventions have not been broadly offered to this population. METHODS: We conducted a retrospective cohort study using electronic health records from 2014 in a large integrated care delivery system to examine whether use of smoking cessation pharmacotherapy among smokers with type 2 diabetes varies by serious mental illness (SMI) diagnosis. We analyzed smoking cessation medication prescription fills among adult smokers with diabetes, comparing those with SMI (N = 634) and without SMI (N = 18,021). Risk ratios were adjusted for age, gender, race, urban area type, and medical facility. RESULTS: Of the SMI group, 19.09% filled at least one smoking cessation prescription compared to 9.73% of the non-SMI group (adjusted risk ratio 1.80 [95% CI 1.52-2.13]; p < .001). For the SMI group, primary care providers wrote 80.24% of prescriptions, while psychiatrists wrote 8.81% of prescriptions. CONCLUSIONS: These findings offer an example of a delivery system with higher uptake of smoking cessation pharmacotherapy among people with SMI than without SMI, and highlight the opportunity to provide more smoking cessation interventions in mental health care settings.
PP - England
PY - 2021
SN - 1873-6327; 0306-4603
SP - 106697
T1 - Smoking cessation treatment for individuals with comorbid diabetes and serious mental illness in an integrated health care delivery system
T2 - Addictive Behaviors
TI - Smoking cessation treatment for individuals with comorbid diabetes and serious mental illness in an integrated health care delivery system
U1 - Healthcare Disparities
U2 - 33129613
U3 - 10.1016/j.addbeh.2020.106697
VL - 114
VO - 1873-6327; 0306-4603
Y1 - 2021
Y2 - Mar
ER -