Patient-mediated scale-up of guideline implementation in primary-care: an open-label trial

Objective To advance the knowledge on how to amplify the impact of effective clinical interventions to the population level, we tested an approach that took the traditional model of care delivery, which relied on busy physician practices to initiate treatment and transformed it into a patient-driven model, enabled by web technology and strategic labor distribution among patient, physician and pharmacist. Varenicline and bupropion are effective pharmacotherapies for smoking cessation, but many clinicians do not proactively discuss these options with their smoker patients. Using cost-free medication as an incentive, our objective was to demonstrate the feasibility of enrolling smokers via the internet in a protocol to engage their family physician in a discussion of smoking cessation treatment with pharmacotherapy.