Abstract A004: Quitxt mobile text messaging cessation program for primary care and cancer patients development and implementation process
Authors: Chalela Patricia , Cortez Vivian , Sivak Sandra G. , Flores Armida , Muñoz Edgar , Despres Cliff , Cancino Ramon , Kitano Mio , Mundlamuri Rahul , Gunnam Ganesh R. , Akopian David , Ramirez Amelie G. 
Published: December 2023

Background: Physicians have unparalleled access to smokers. It is estimated that over 70% of smokers visit a physician every year, which provides a powerful opportunity to promote tobacco cessation by asking about smoking behaviors and providing cessation advice and counseling to tobacco users at every visit. In general, smokers consider a physician’s advice to quit an important motivator to make a quit attempt. Every patient is screened for tobacco use; if the patient is a tobacco user, healthcare providers (HCPs) advise them to quit, offer nicotine replacement therapy if needed, and recommend enrollment in the Quitxt program to receive daily messages from the program as well as patient navigator support. Purpose: To conduct a system change to facilitate the integration of Quitxt into the healthcare setting of the Primary Care Center (PCC) and the Mays Cancer Center (MCC) at UT Health San Antonio, to increase accessibility and utilization of a bilingual, evidence-based tobacco cessation service among patients. Methods: We adapted our Quitxt program to the patient population attending the PCC and MCC, integrated it into EPIC, and added it to the Best Practice Advisories Banner. All patients are screened for tobacco use, and if a tobacco-using patient is identified, the Best Practice Advisories banner appears on HCPs’ screen, prompting them to counsel patients to quit and encourage them to enroll in Quitxt. Enrollment cards are available in exam rooms and help providers talk about the program and provide information on how to enroll. The EPIC system also places instructions on how to enroll in Quitxt in the patients’ after-visit summary. Selecting referral to Quitxt activates our Patient Navigators (PNs) follow-up. PNs contact patients monthly and provide support, positive reinforcement, and encouragement. They continue with monthly follow-ups throughout the duration of the program (6 months). Results: To date, 194 patients have been referred to the BestPractice basket. PNs made 829 follow-up phone calls. Of those patients, 104 have enrolled in the program. So far, 96% are English speakers, with a mean age of 47 yrs (SD 11.4); 64% female, 38% Hispanic, the mean number of cigarettes smoked per day was 12, and 60% were ready to make a quit attempt the next day. Preliminary results show cessation rates of 22.1% at day 1; 26.2% at 7 days; 20.4% at 1 month; 31.4% at 4 months and  27.6% at 6 months. Conclusion: Integrating Quitxt into the healthcare setting increases the accessibility and utilization of the Quitxt cessation service among primary care and cancer patients. Quitxt can be easily replicated and represents an affordable approach to reach tobacco-using patients, produce a public health impact, and reduce health service costs and tobacco-related diseases and mortality.

Citation Format: Patricia Chalela, Vivian Cortez, Sandra G. Sivak, Armida Flores, Edgar Muñoz, Cliff Despres, Ramon Cancino, Mio Kitano, Rahul Mundlamuri, Ganesh R. Gunnam, David Akopian, Amelie G. Ramirez. Quitxt mobile text messaging cessation program for primary care and cancer patients development and implementation process [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr A004.