Improving Equity and Consistency in Hospital Prescribing of Smoking Cessation Pharmacotherapy

A research team comprised of researchers from Washington University in St Louis and Barnes Jewish Hospital, supported by faculty and staff at the Social Systems Design Lab, is embarking on a multi-step, mixed-method approach to develop a stakeholder-supported strategy for equitable smoking cessation prescribing practices. On a local level, despite national trends of declining cigarette smoking, nearly one-third of all admissions at Barnes-Jewish Hospital remain to be cigarette smokers. Smoking prevalence is particularly high in African-Americans, men, those aged 18-64 and those admitted through the emergency room. Preliminary data illustrate that of all hospital admissions who smoke, African-Americans are 40% less likely than European Americans to be prescribed smoking cessation pharmacotherapies during their hospital stay. Through a series of workshops that employ community based system dynamics, the research team engages relevant stakeholders in the current prescribing practices. The project seeks to develop a model that will inform development and trial of a strategy aimed to reduce racial disparities and facilitate more consistent smoking cessation prescribing practices in the hospital.

Project Goals

• Utilize community based system dynamics to understand factors that preclude higher rates of smoking cessation treatment and give rise to the observed racial disparity in hospital prescribing practices
• Develop a model that outlines integration and utilization of equitable prescribing of smoking cessation medications
• Produce a deliverable that will be used to further engage stakeholders in the development and trial of a strategy to reduce racial disparities and facilitate more consistent smoking cessation prescribing practices in the hospital

Publications