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Purpose: Tobacco use disorder is commonly comorbid in patients with Opioid Use Disorder (OUD), yet not always regularly addressed during OUD treatment. The aim of this project was to assess tobacco cessation intervention at a small outpatient medication assisted treatment (MAT) program and improve workflow to standardize care, increase knowledge and encourage tobacco cessation among patients.

Methods: The Plan Do Study Act (PDSA) method of quality improvement was used. Patient medical records were reviewed to assess documentation of tobacco use status and readiness to quit in the electronic health record (EHR). A screening, brief intervention, and referral to treatment (SBIRT) protocol was implemented. Pre- and post-intervention data were used to assess impact on knowledge, workflow, and patient readiness to quit.

Results: After 5 months, 17 patients completed the pre-intervention survey and 7 completed the post-intervention survey. Documentation of patient smoking status in the EHR improved from 20% to 57% post-implementation. Results showed an increased readiness to quit and understanding of tobacco cessation and treatment options. Clinicians reported a positive impact on workflow.

Conclusion: This small-scale quality improvement study shows that SBIRT implementation in outpatient OUD treatment settings has the potential to increase tobacco cessation readiness and treatment during OUD treatment, therefore improving outcomes for this high-risk population. Many barriers limited the impact of the intervention. Overall, a positive effect on both patients and healthcare providers was found.

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