EHR Alert for Tobacco Use Disorder

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Medical University of South Carolina

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests a new electronic health record (EHR) alert system to assist doctors in prescribing nicotine replacement therapy (NRT) for patients who smoke. The goal is to determine if this alert increases NRT prescriptions both in the hospital and after discharge. The trial involves two groups of doctors: one with the alert and one without. Potential participants are patients admitted to a general medicine service in Charleston and identified as smokers during nursing screenings. As an unphased trial, this study provides patients the opportunity to contribute to innovative research that could enhance smoking cessation support in healthcare settings.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What prior data suggests that this EHR alert is safe for use in hospitals?

Research has shown that nicotine replacement therapy (NRT) is generally safe for helping people quit smoking. It has been widely studied and used to treat tobacco dependence. In these studies, most participants found NRT easy to use without major issues.

Some mild side effects, such as skin irritation from patches or slight nausea from gum or lozenges, have been reported. However, these effects are usually not serious.

Importantly, long-term use of NRT has also been shown to be safe. It can help reduce smoking and increase the chances of quitting for good. For those considering joining a trial involving NRT, existing evidence suggests it is a safe option to consider. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about this trial because it introduces a unique approach to treating Tobacco Use Disorder by integrating an Electronic Health Record (EHR) alert system. Unlike traditional methods that rely heavily on healthcare providers manually assessing and prescribing Nicotine Replacement Therapy (NRT), this system automatically inserts smoking history into patient records and prompts NRT prescribing during hospital stays. Additionally, it offers a direct referral for outpatient follow-up, streamlining the treatment process. This innovative use of technology aims to enhance the consistency and efficiency of care, potentially leading to better patient outcomes in quitting smoking.

What evidence suggests that this EHR alert is effective for increasing NRT prescribing?

Research has shown that nicotine replacement therapy (NRT) can increase the chances of quitting smoking by 50 to 70%. Without assistance, only 1 or 2 out of 10 people might succeed in quitting. However, with NRT, 5 to 7 people could succeed. One study found that combining NRT with support like counseling enables about 15% of people to quit smoking over six months. This evidence suggests that NRT is a helpful tool for quitting smoking. In this trial, participants in the experimental arm will receive an EHR alert prompting NRT prescribing, while the control group will receive routine care without the EHR alert. ^{2 3 6 7 8}

Who Is on the Research Team?

Ellen Esposito, MD

Principal Investigator

Medical University of South Carolina

Are You a Good Fit for This Trial?

This trial is for hospitalized patients with nicotine addiction or tobacco use disorder. It's focused on whether an electronic health record (EHR) alert can help doctors remember to prescribe nicotine replacement therapy (NRT) during the hospital stay and at discharge.

Inclusion Criteria

Hospitalized patients admitted to a General Medicine Service at MUSC Charleston

Identified as actively smoking tobacco via nursing admission screening

Admitted by a resident physician participating in the study (as indicated by the H&P note)

Exclusion Criteria

Not applicable.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intervention

Implementation of a non-interruptive EHR alert to increase NRT prescribing in hospitalized patients

Duration not specified

In-hospital intervention

Follow-up

Participants are monitored for changes in prescribing behaviors and smoking cessation outcomes

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Nicotine Replacement Therapy Prescribing

Trial Overview The study tests a new EHR-based alert system designed to remind resident physicians to prescribe NRT for smokers who are in the hospital. The effectiveness of this non-interruptive reminder will be compared between two groups of doctors.

How Is the Trial Designed?

Group I: EHR alert Experimental Treatment 1 Intervention

Group will have access to the EHR embedded alert into the admission note template, where it automatically inserts smoking history, prompts NRT prescribing in the hospital, and offers referral to outpatient follow up.

Group II: Control Active Control 1 Intervention

Routine care, no access to the EHR embedded alert

Who Is Running the Clinical Trial?

Medical University of South Carolina

Lead Sponsor

Trials

994

Recruited

7,408,000+

South Carolina Clinical & Translational Research Institute (SCTR)

Collaborator

Trials

1

Recruited

70+

Citations

1. pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov/23152200/

Nicotine replacement therapy for smoking cessation NRTs increase the rate of quitting by 50 to 70%, regardless of setting. The effectiveness of NRT appears to be largely independent of the ...

2. academic.oup.com academic.oup.com/ntr/article/27/10/1695/8129442

Effectiveness of Nicotine Replacement Therapy and ... In a meta-analysis, the combination of pharmacotherapy and BI was associated with a quit rate of 15.2% over 6 months; in contrast, brief advice or usual care ...

3. tobaccopreventioncessation.com tobaccopreventioncessation.com/The-effectiveness-of-nicotine-replacement-therapy-on-oral-smokeless-tobacco-cessation,208023,0,2.html

The effectiveness of nicotine replacement therapy on oral ... These two studies found that the high dose of NRT was associated with increased OST abstinence rate as a result of a greater reduction in ...

4. frontiersin.org frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2025.1525510/full

Nicotine replacement therapy as a smoking cessation tool ... Results: NRT demonstrated limited success in long-term smoking cessation among adolescents, with low cessation rates that often declined post- ...

5. tobaccocontrol.bmj.com tobaccocontrol.bmj.com/content/32/3/302

Effectiveness of ENDS, NRT and medication for smoking ... The percentages of quitting smoking among those who used ENDS, NRT, non-NRT medication, and a combination of NRT and non-NRT medication were 16.2% (n=14), 16.1% ...

6. ncbi.nlm.nih.gov ncbi.nlm.nih.gov/books/NBK493148/

Nicotine Replacement Therapy - StatPearls - NCBI Bookshelf Nicotine replacement therapy (NRT) is designed for individuals who wish to quit smoking. Abruptly discontinuing smoking can trigger withdrawal ...

7. tobaccoinduceddiseases.org tobaccoinduceddiseases.org/Adverse-events-associated-with-nicotine-replacement-therapy-NRT-for-smoking-cessation,65973,0,2.html

Adverse events associated with nicotine replacement ... Nicotine replacement therapy (NRT) is the most common form of smoking cessation pharmacotherapy and has proven efficacy for the treatment of tobacco dependence.

8. clinicaltrials.gov clinicaltrials.gov/study/NCT02148445

Smoking Cessation Versus Long-term Nicotine ... Long-term NRT is safe; it can reduce the rewarding effects of cigarettes, reduce the amount that people smoke, and increase quit rates. Long-term NRT has not, ...