The research team from Imperial College London looked at patients with diabetes, registered in Wandsworth, South London. They found that the percentage of smokers with diabetes who were given cessation advice by primary care staff increased from 48 percent to 84 percent between 2003 and 2005. More patients with diabetes had their smoking status recorded in 2005 (99 percent) than in 2003 (91 percent). The percentage of people with diabetes who smoked decreased from 20 percent in 2003 to 16 percent in 2005.
Under "pay-for-performance," practices are judged against 146 quality indicators, as part of the new general practitioner (GP) contract introduced in 2004. Several of these quality indicators encourage GPs to identify people with a chronic disease, such as diabetes or heart disease, who smoke and provide advice and support to help them quit smoking. About one quarter of GP income is currently derived through meeting quality targets in the treatment of such chronic diseases.
Previous studies had showed that GPs were not routinely offering cessation advice during consultations, in spite of evidence showing that it improves quit rates, because some found it too time-consuming, considered it to be ineffectual, or felt that they lacked the appropriate skills.
The researchers' findings suggest that the new incentive scheme is likely to be a key contributor to changes in help offered to smokers. However, they caution that some of the improvements seen may have occurred without the introduction of financial incentives.
Christopher Millett, one of the authors from the study from the Department of Primary Care and Social Medicine at Imperial College London, said: "Improvements were generally greatest in the groups with the poorest performance before these incentives were introduced and among ethnic minorities - populations that often receive lower quality care.”
MEDICA.de; Source: Imperial College London