Coronary Artery Disease and Smoking Cessation Intervention by Primary Care Providers in a Rural Clinic

Abstract

Among numerous risk factors for coronary artery disease (CAD), including family history, hypertension, diabetes mellitus and dyslipidemia, the single most modifiable risk factor is smoking. Smoking cessation for known CAD patients has recognized immediate and long term benefits, namely reduction in the chance of symptom recurrence and death. This article is a description of an evaluation of smoking cessation intervention by primary care providers for patients who smoke with a known history of CAD within 1 year of diagnosis. Nola J. Pender’s revised Health Promotion Model was the framework for this non-experimental, quality assurance study using descriptive retrospective chart review in a rural family practice clinic in the southern United States. Data were collected using a researcher-developed quality assurance tool with a final sample of 150 patient medical records. Results indicated that over two thirds (68.7%) of the patient sample received smoking cessation therapy prior to or within 1 year after diagnosis of CAD; however, 31.3% of the patient sample received no smoking cessation intervention. Although a large percentage of this sample received smoking cessation therapy, the American Heart Association and American College of Cardiology recommend smoking cessation therapy for all smokers with known history of CAD at each visit. It is recommended that this guideline be followed in all patients regardless of compliance with smoking cessation therapy, and that this therapy be consistently evaluated in its culturally relevant application to rural populations.