Do you vape? Leveraging electronic health records to assess clinician documentation of electronic nicotine delivery system use among adolescents and adults

PREVENTIVE MEDICINE

卷:105

Article

Young-Wolff, Kelly C.¹  Klebaner, Daniella¹  Folck, Bruce¹  Carter-Harris, Lisa²  Salloum, Ramzi G.³  Prochaska, Judith J.⁴  Fogelberg, Renee⁵  Tan, Andy S. L.^6,7 

[1] Kaiser Permanente Northern Calif, Div Res, 2000 Broadway, Oakland, CA 94612 USA

[2] Indiana Univ, Sch Nursing, Indianapolis, IN 46204 USA

[3] Univ Florida, Coll Med, Inst Child Hlth Policy, Dept Hlth Outcomes & Policy, Gainesville, FL USA

[4] Stanford Univ, Stanford Prevent Res Ctr, Stanford, CA 94305 USA

[5] Kaiser Permanente Northern Calif, Richmond Med Ctr, Richmond, CA USA

[6] Dana Farber Canc Inst, Div Populat Sci, Boston, MA 02115 USA

[7] Harvard TH Chan Sch Publ Hlth, Dept Social & Behav Hlth, Boston, MA USA

关键词: Electronic nicotine delivery systems;    Electronic health record;    Integrated healthcare;    Natural language processing;    Adolescents;    Clinicians;    E-cigarettes;    Vaping;    Semantics;   

DOI  :  10.1016/j.ypmed.2017.08.009

来源: Elsevier

【 摘 要 】

Use of electronic nicotine delivery systems (ENDS) has increased substantially over the past decade. However, unlike smoking, which is systematically captured by clinicians through routine screening and discrete documentation fields in the electronic health record (EHR), unknown is the extent to which clinicians are documenting patients' use of ENDS. Data were gathered from medical visits with patients aged 12 and older (N = 9,119; 55% male) treated in a large, integrated healthcare system. We used natural language processing to assess the incidence rates of clinician documentation of patients' ENDS use in unstructured tobacco comments in the EHR, and the words most frequently documented in relation to ENDS, from 2006-2015. ENDS documentation in the EHR increased dramatically over time (from 0.01 to 9.5 per 10,000 patients, p < 0.0001), particularly among adults aged 18-24 and 25-44. Most prevalent were e-cig, electronic cigarettes, and vape, with much variation in spelling and phrasing of these words. Records of adolescent and young adult patients were more likely to contain the word vape, and less likely to have e-cig andelectronic cigarette than records of adults (ps < 0.0001). The relatively low observed number of patients with ENDS terms in the EHR suggested vast under documentation. While healthcare providers are increasingly documenting patients' use of ENDS in the EHR, overall documentation rates remain low. Discrete EHR fields for standard screening and documentation of ENDS that reflect the language used by patients would provide more complete longitudinal population-level surveillance of ENDS use and its association with short-and long-term health outcomes.

【 授权许可】

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