Utilisation of physician reminders about smoking cessation improves patient outcome


  • Mohammed Qasim Darr Department of Family Medicine, Primary Health Care Corporation, Doha, Qatar
  • Sanaullah Sheik Department of Family Medicine, Primary Health Care Corporation, Doha, Qatar




Documentation, Physician reminder, Smoking


Background: Smoking is a major risk factor for cardiovascular disease and is prevalent amongst 18-64-year-olds (31.9%) in Qatar. Disease prevention through health promotion remains the cornerstone of physicians workload in primary care. Physician reminders (PR) be it electronic or physical can prompt doctors to offer smoking cessation services, hopefully reducing disease burden. The objective was to improve the identification of smokers and provision of smoking cessation services using a PR system in primary care.

Methods: A prospective quality improvement project in a primary care health centre focusing on physician practices towards smokers. We analyzed physicians’ documentation post consultation looking for specific end points like use of the code “smoker” and referral rates to the smoking cessation clinic (SCC). Data was collected with and without use of a PR (used to identify smoker) and then compared for the difference in documentation and services offered.

Results: The use of a physician reminder vastly improved the identification of smokers. This led to an increase in the use of the code ‘smoker’ by physicians by 43.5%. Documentation of smoking status and the provision of smoking cessation counselling both improved by 32.8%.  There was an increase in referral rates (18.8%) to the SCC due to use of the physician reminder. There was a 7.9% rise in smokers attending the SCC.

Conclusions: Using a physician reminder helped to improve the identification of smokers and patient provision of smoking cessation services such as referral to the SCC. Repeating the study using an electronic physician reminder incorporated within the EMR system would be beneficial given the findings from this study.


World Health Organisation. Qatar STEPS Survey 2012. Available at: https://cdn.who.int/media/ docs/default-source/ncds/ncd-surveillance/data-reporting/qatar/steps/qatar-factsheet-2012.pdf?sf vrsn=2e4a4e16_2&download=true#:~:text= The%20STEPS%20survey%20in%20Qatar,overall%20response%20rate%20was%2088%25. Accessed on 3 February 2021.

Primary Health Care Corporation. No Smoking Policy of Primary Health Care Corporation.; 2020. Available at: https://www.phcc.gov.qa. Accessed on 1 June 2023.

International Diabetes Federation. Diabetes in Middle-East and North Africa- 2021. International Diabetes Federation. 2021:6-7. Available at: https://diabetesatlas.org/idfawp/resource-files/2021/11/IDF-Atlas-Factsheet-2021_MENA.pdf. Accessed on 4 February 2021.

Centers for Disease Control and Prevention. Tips From Former Smokers®. 2018. Available at: https://www.cdc.gov/tobacco/campaign/tips/index.html. Accessed on 4 February 2021.

Primary Health Care Corporation. Initial client medical assessment and re-assessment policy. Primary Health Care Corporation; 2022.

American Association of Family Practitioners. Ask and Act Tobacco Cessation Program. American Association of Family Practice. Available at: https://www.aafp.org/family-physician/patient-care/care-resources/tobacco-and-nicotine/ask-act.html. Accessed on 10 June 2023.

Lega IC, McLaughlin H, Coroneos M, Handley-Derry F, Donovan N, Lipscombe LL. A physician reminder to improve postpartum diabetes screening in women with gestational diabetes mellitus. Diabetes Res Clin Pract. 2012;95(3):352-7.

Tierney WM, Miller ME, Overhage JM, McDonald CJ. Physician inpatient order writing on microcomputer workstations. Effects on resource utilization. JAMA. 1993;269(3):379-83.

Fenerty SD, West C, Davis SA, Kaplan SG, Feldman SR. The effect of reminder systems on patients’ adherence to treatment. Patient Prefer Adher. 2012;6:127-35.

McGlynn EA, Asch SM, Adams J, Keesey J, Hicks J, DeCristofaro A, et al. The quality of health care delivered to adults in the United States. N Engl J Med. 2003;348(26):2635-45.

Dexheimer JW, Talbot TR, Sanders DL, Rosenbloom ST, Aronsky D. Prompting clinicians about preventive care measures: a systematic review of randomized controlled trials. J Am Med Inform Assoc. 2008;15(3):311-20.

Frances CD, Alperin P, Adler JS, Grady D. Does a fixed physician reminder system improve the care of patients with coronary artery disease? A randomized controlled trial. West J Med. 2001;175(3):165-6.

Rosser WW, McDowell I, Newell C. Use of reminders for preventive procedures in family medicine. CMAJ. 1991;145(7):807-14.

Sequist TD, Zaslavsky AM, Marshall R, Fletcher RH, Ayanian JZ. Patient and physician reminders to promote colorectal cancer screening: a randomized controlled trial. Arch Intern Med. 2009;169(4):364-71.

Reitsma MB, Kendrick PJ, Ababneh E. Spatial, temporal, and demographic patterns in prevalence of smoking tobacco use and attributable disease burden in 204 countries and territories, 1990–2019: a systematic analysis from the Global Burden of Disease Study 2019. Lancet. 2021;397(10292):2337-60.

Tobacco Use and Dependence Guideline Panel. Treating Tobacco Use and Dependence: 2008 Update. US Department of Health and Human Services; 2008.




How to Cite

Darr, M. Q., & Sheik, S. (2023). Utilisation of physician reminders about smoking cessation improves patient outcome. International Journal Of Community Medicine And Public Health, 10(10), 3496–3501. https://doi.org/10.18203/2394-6040.ijcmph20233077



Original Research Articles