Documentation of the patient’s smoking status in common chronic diseases – analysis of medical narrative reports using the ULMFiT based text classification

Documentation of smoking in scheduled asthma contacts in primary health care: a 12-year follow-up study

“…To the best of our knowledge, no previous real-life studies exist on how smoking status and the quantities of pack-years are documented in scheduled asthma contacts in PHC in long-term follow-up, and how often during the follow-up the patients are advised to quit smoking. Studies assessing documentation of smoking often include, also, patients with COPD or other chronic diseases 13 , 21 , 44 – 47 . A previous review reported that failure to adequately document smoking history is common in asthma but also in other conditions 44 .…”

“…Among ex-smokers and current smokers ( n = 73), smoking was documented in less than half (47%) and pack-years less than in 7% of the patients. Recent registry-based study from Finnish secondary care showed that among asthmatics smoking status was documented in 61% of patients and that clinicians documented smoking more actively in years 2016–2018 than in years 2010–2012 47 . The patients included in the previous study were either diagnosed for the first time with disease or they were referred to secondary care for treatment optimization 47 .…”

“…Recent registry-based study from Finnish secondary care showed that among asthmatics smoking status was documented in 61% of patients and that clinicians documented smoking more actively in years 2016–2018 than in years 2010–2012 47 . The patients included in the previous study were either diagnosed for the first time with disease or they were referred to secondary care for treatment optimization 47 . Thus, it could be argued that due to this fact smoking was more likely to be documented and, on the other hand, use of preliminary information forms is more common in secondary care in Finland, which may have made smoking information more visible.…”

“…In our study, out of the patients who succeeded to quit smoking, 43% had received smoking cessation advise during scheduled asthma contacts in PHC. Recent Finnish study showed that smoking cessation was discussed with 55.4% of current smoker asthmatics in secondary care, but still these patients were seldom referred to nurse-managed smoking cessation program 47 .…”

“…Our results raise doubts whether PHC professionals are truly aware of the importance of evaluation of smoking and smoked pack-years among asthma patients, and whether these are better screened with COPD patients as smoking is a well-known risk factor for the disease 23 . Recent study from Finland showed that smoking status was documented more frequently in COPD and sleep apnea patients in secondary care, and that smoking cessation was discussed more frequently in COPD (59.5%) and type I diabetes (61.0%) than in asthma (55.4%) 47 . In U.S. was also found that PHC physicians provided counseling more frequently to smokers with COPD than smokers without chronic diseases (46% vs 25%) or with asthma (31%) 21 .…”