Table 1 Study characteristics

Domain 5. Train and educate stakeholders

  Mullins, 1999 [70]

Victoria, Australia

40. Distribute educational materials

Repeated cross-sectional study

Analytical

Aged 16 years and over, smokers

1990: n = 624

1992: n = 596

1994: n = 609

1996: n = 563

Data source: Population-based survey of adults in Victoria

Outcome measure:

Practitioner-level: Each year, smokers were shown a card, and asked, “Which of any of those things has your GP ever said to you?”. Mutually exclusive categories were created by developing a hierarchy of response, and each respondent was coded according to the most appropriate advice he or she had ever been given

  Vasankari, 2011 [74]

Finland

42. Conduct educational meetings

Repeated cross-sectional study

Analytical

Aged 16 years and over, respiratory symptoms

1997: n = 1,072 patients

2002: n = 1,645 patients

Data source: Electronic patient record system of one "medium-sized primary healthcare center in south-west Finland with computerized patient records"

Outcome measure:

Practitioner-level: "history of smoking", "data on smoking status available"

Domain 7. Engage consumers

  Szatkowski, 2011 [33]

England

54. Prepare patients/consumers to be active participants

Repeated cross-sectional study

Interrupted time series analysis (no control)

Aged 16 years and over, smokers

2000 to 2009: n = missing

Data source: UK-representative primary care electronic healthcare records, THIN

Outcome measure:

Practitioner-level: British National Formulary drug codes were used to identify smokers with one or more prescriptions for NRT, bupropion or varenicline recorded in their notes each month. Not enough data to model trends in prescribing of varenicline

  Langley, 2012 [46]

England (and Wales)

56. Use mass media

Repeated cross-sectional study

Interrupted time series analysis (no control)

Unspecified

January 2002 to June 2009: n = missing

"Some of the outcome data cover England only, but due to the make-up of the United Kingdom's TV regions, TVRs for Wales cannot be separated from those for England."

Data source: UK-representative primary care electronic healthcare records, THIN

Outcome measure:

Practitioner-level: "prescribing of NRT"

Domain 8. Utilize financial strategies

  Alageel, 2019 [31]

England

57. Fund and contract for the clinical innovation

Cohort study

Interrupted time series analysis (with control)

Aged between 40–74 years

Intervention group: had a health check recorded between 1 April 2010 and 31 December 2013 (Read medical codes indicating that a health check or CVD risk assessment was completed) (n = 127,891 participants, from 431 general practices in England)

"Consistent with the eligibility criteria for the NHS Heath Check, health check participants were excluded if they had diagnoses of ischaemic heart disease, stroke or diabetes, or were treated with antihypertensive drugs or statins before the date of the health check."

Matched cohort: matched for age, sex, and general practice, participants who did not receive the check with follow-up data available up to the latest date of 31 March 2017 (n = 322,910)

Data source: UK-representative primary care electronic healthcare records, CPRD

Outcome measure:

Practitioner-level and patient-level: "Read codes relating to smoking and smoking advice." "Product codes indicating prescription of smoking cessation therapy."

"Smoking cessation interventions were divided into two categories: referrals to a smoking-cessation advisor or stop smoking clinic and medication (nicotine replacement therapy)."

  Bennett, 2008 [65]

Ireland

57. Fund and contract for the clinical innovation

Cohort study

Patients with diagnosis of coronary heart disease ("patients attending primary care from February 2003 after an acute myocardial infarction (AMI) or coronary intervention, such as percutaneous coronary intervention or coronary artery bypass grafting, which may have been recent or some time ago."

2004, 1-year follow-up cohort: n = 7,099 patients, 84.4% had four or five visits over the year

2005, 2-year follow-up cohort: n = 4,011 patients, 60.5% had at least eight or nine visits over 2 years

Data source: Primary care electronic medical records. 470 (20%) of all Irish GPs were selected to participate in the programme

Outcome measure:

Patient-level: "the percentage smoking prevalence was calculated based on an individual having at least one of the following recorded: smoker of one or more cigarettes per day, cigar or pipe smoker."

"Absolute change in risk factors between baseline and the 1-year or 2-year follow-up visit was calculated."

  Fitzpatrick, 2011 [66]

Ireland

57. Fund and contract for the clinical innovation

Cohort study

Patients with diagnosis of coronary heart disease (significant proven coronary heart disease (CHD); a history of myocardial infarction (MI), percutaneous coronary intervention or coronary artery bypass graft surgery)

2004, 1-year cohort: n = 8,309 patients

2005, 2-year cohort: n = 5,431 patients

2006, 3-year cohort: n = 3,470 patients

2007, 3.5-year cohort: n = 2,078 patients

Data source: Primary care electronic medical records. The programme involved 480 (20%) of general practices

Outcome measure:

Patient-level: "The percentage smoking was calculated based on an individual having one or more of the following recorded — smoker of one or more cigarettes per day, cigar or pipe."

"Absolute changes in risk factors between baseline and follow-up were calculated."

"medication prescription" **raw figures not available for smoking cessation medication prescription

  Forster, 2016 [48]

England

57. Fund and contract for the clinical innovation

Cohort study

Aged between 40–74 years

Intervention group: had a health check recorded between 1 April 2010 and 31 March 2013, never treated with antihypertensive drugs or statins, and not diagnosed with diabetes, stroke or coronary heart disease before the check (n = 91,618 patients)

Control group: (n = 182,245 patients), matched controls were identified for 75,123 (82%) of the intervention group

Data source: UK-representative primary care electronic healthcare records, CPRD

Outcome measure:

Practitioner-level: "The date of each risk factor record was evaluated with reference to the date of the Health Check (the date of the check was the reference date for the cases and their matched controls were also assigned this date of the check). We evaluated risk factor detection, including … the proportion with current smoking recorded…"

  Frijling, 2003 [69]

Netherlands

57. Fund and contract for the clinical innovation

Controlled before-and-after trial

Aged 60 years and over, with high cardiovascular risk (diagnosed with diabetes, hypertension, hypercholesterolaemia, have cardiovascular disease history or family history of coronary heart disease)

Intervention group: 420 practices randomly invited from the 800 practices participating in the nationwide project. Response to baseline (October 1998) and post-intervention (September 2000) questionnaire: 316 GPs (84.0%)—returned the shortened version of the post-intervention questionnaires: 37 GPs (11.7%)

Control group: 600 practices randomly invited from the 4000 practices which did not participate in the nationwide project. Response to baseline (October 1998) and post-intervention (September 2000) questionnaire: 301 GPs (77.2%)—returned the shortened version of the post-intervention questionnaires: 74 GPs (24.6%)

Data source: GP postal questionnaire

Outcome measure:

Practitioner-level: "The information was provided by one GP per practice and the same GP for both measurement points."

"Assessment of … the following risk factors: … smoking habits."

"the GPs were asked whether the minimal contact intervention (MCI) for smoking cessation was used in their practices"

  Pajak, 2010 [73]

Poland

57. Fund and contract for the clinical innovation

Cohort study

Aged between 35–55 years. "Free of cardiovascular disease and with medical documentation going back to at least 1 January 2005". The final examination was conducted in 2007

Active clinics: 33 clinics, n = 3,940 patients. n = 1,244 patients (31.6%) participated in the PCVDP. Participated in final examination: n = 2,314 patients (58.7%)

Control clinics: 33 clinics, n = 3,162 patients. Participated in final examination: n = 2,107 patients (66.6%)

Data source: Patient healthcare records, patient questionnaire

Outcome measure:

Practitioner-level: "Information on risk factors (smoking)" in patient healthcare records

Patients were interviewed by a trainer interviewer, current smoker patients were asked whether they received "verbal advice or leaflets" regarding tobacco cessation, whether they were "referred to a specialist clinic", whether they received "pharmacotherapy", and whether they discussed "other methods" regarding tobacco cessation

Patient-level: Patients reaching "prevention targets" ("not smoking"), but this seems to be 'non-smoking prevalence at final examination'

  Wright, 2018 [71]

Australia

57. Fund and contract for the clinical innovation

Cohort study

Aboriginal and Torres Strait Islander people, aged 15 years and over, "has attended the health service [at least] three times in the past 2 years", 2014–2016

65% of all services that provide national key performance indicator (nKPI) data (152/233) were included: 44 TIS currently funded services and 108 non-TIS-funded services

‘Exposure’ was defined as an organisation that was funded (n = 44/152) either directly or indirectly (via consortium arrangements) by the Australian Government’s TIS program

2016: n = 81,187 clients accessed TIS-funded services, n = 85,098 clients accessed non-TIS-funded services

Data source: Aggregate service-level patient electronic health records; national key performance indicator (nKPI) data

Outcome measure: "(1) the number (and proportion) of clients with a smoking status recorded in the health service records; and (2) the number (and proportion) of clients with smoking status recorded as current, ex- and non-smoker."

**Timeline of intervention is unclear. TIS program started in 2016. This study uses 2014 as the pre-intervention timepoint, and 6-months into 2016 as the post-intervention/during intervention timepoint

  Bailey, 2016 [54]

Oregon, USA

59. Place innovation on fee for service lists/formularies

Cohort study

Aged between 19–64 years, smokers. "Low-income adults". Pregnant women excluded

Intervention group: n = 5,935 patients gained Oregon Medicaid coverage between 2008 and 2011 after being uninsured for ≥ 6 months and who maintained this insurance for ≥ 6 months

Control group: n = 9,371 patients who did not gain Medicaid, patients who were continuously uninsured throughout the 24-month follow-up period and met the current smoker criteria

Final study sample included 4,140 matched pairs (n = 8,280 patients)

Data source: Primary care electronic healthcare records (Oregon Community Health Information Network, “OCHIN, Inc.”)

Outcome measure:

Patient-level: "…discrete data field for smoking status, and the OCHIN workflow requires review of tobacco use status at each primary care encounter." "smoking status (i.e., current every day, current some day, former, or never smoker) can be confirmed or modified, and the reviewed or changed date is saved in the EHR. Tobacco cessation medications were abstracted from EHR medication order data." "Our primary outcome was ‘quit’ smoking status after the baseline assessment, coded as a binary yes/no variable. A person was identified as ‘quit’ if baseline smoking status was ‘current every day’ or ‘some day’ and status changed to ‘former smoker’ at a subsequent visit.”

Practitioner-level: “We also assessed prevalence of having a smoking cessation medication ordered (yes/no), and analyzed quit smoking status stratified by whether medication was ordered. Medications included bupropion, varenicline, and all nicotine replacement products."

  Bailey, 2020 [60]

United States (multi-state)

59. Place innovation on fee for service lists/formularies

Cohort study

Aged between 19–64 years. Tobacco user. Pregnant women excluded

Intervention group: Medicaid-expansion states from 1 January 2014 (California, Hawaii, Maryland, Minnesota, New Mexico, Ohio, Oregon, Rhode Island, Washington, and Wisconsin), n = 219 primary care community health centres (CHCs). n = 62,164 patients

Control group: non-Medicaid-expansion states (Florida, Kansas, Missouri, North Carolina, Texas, and Montana). n = 108 primary care CHCs. n = 31,881 patients

States had electronic health records from 1 January 2013. Outcomes assessed 24-months post-expansion: 31 December 2015

Propensity score matched comparison sample: expansion states (n = 27,670 patients), non-expansion states (n = 27,670 patients)

Data source: Electronic medical records (from primary care community health centres (CHCs)… This study used CHC data from the OCHIN network and the Health Choice Network (HCN)."

Outcome measure:

Patient-level: "The EHR presents a discrete data field for tobacco use status at each primary care encounter, which can be confirmed, updated, or not reviewed. If confirmed or updated, the date is saved. Our primary outcome was tobacco cessation (“quit”) during the post-period, coded as a binary yes/no variable. … a person was identified as “quit” if the last recorded tobacco-use status during the pre-period indicated that the patient was a current user, and if there was at least one subsequent measurement documented in the post-period that indicated the patient’s status was a “nonuser” (eg, former user, not a current user)."

Practitioner-level: "tobacco cessation medications from EHR medication orders: bupropion, varenicline, and all nicotine replacement products"

  Li, 2018 [61]

United States (multi-state)

59. Place innovation on fee for service lists/formularies

Repeated cross-sectional study

Descriptive

Aged between 55–80 years. No evidence of lung cancer. Had at least one office visit to a Family Medicine or Internal Medicine provider between 1st January 2010 and 31st December 2016

2010 to 2016: n = 1,572,538 patient years

Data source: "Electronic health records (EHR) data from patients in a large community healthcare system located in northern California"

Outcome measure:

Practitioner-level: "Annual rate of documentation of smoking history is the proportion of patients who had documented smoking history among those with at least one visit in the year."

  Marino, 2016 [62]

Oregon, USA

59. Place innovation on fee for service lists/formularies

Cohort study

Aged between 19–64 years

"From a “reservation list” of > 100,000 entries, approximately 30,000 people were randomly selected to apply, and approximately 10,000 gained health insurance (Medicaid) coverage in 2008." In the study, the authors attempted to identify people who gained coverage and patients who were on the reservation list but were not selected to gain coverage. Outcomes assessed 36-months after the selection date (~ 2011)

Intervention group: Randomly selected to apply for health insurance coverage: n = 4,049 people. Gained health insurance coverage: n = 1,718 people (44% of n = 4,049 actually gained coverage)

Control group: Not selected to apply for health insurance coverage: n = 6,594 people

Data source: Primary care electronic healthcare record (EHR) data from 49 community health centres (CHCs), OCHIN community health information network (OCHIN, Inc.), in Oregon state

Outcome measure:

Practitioner-level: "The primary outcomes were whether or not the patient received preventive care services in the post-period: … smoking. Codes were used based on EHR Meaningful Use Stage 1 measures." "Screening for smoking", "assessment of smoking status"

  Miraldo, 2018 [57]

Massachusetts, USA

59. Place innovation on fee for service lists/formularies

Repeated cross-sectional study with control

Difference-in-differences (DD) and triple differences (DDD) design

Aged between 18–64 years. Had low income (income below 300% of the federal poverty level)

Intervention group: Massachusetts

Control group: other New England States (ONES) (Connecticut, New Hampshire, Rhode Island, Maine and Vermont), and higher income groups in Massachusetts who were unaffected by the reform

Differences-in-differences (DD) method: Massachusetts vs ONES. "The total sample used for the difference-in-differences (DD) analysis consisted of 131,002 individuals; 39,745 from Massachusetts and 91,257 from ONES."

Triple differences (DDD) method: low income and high income patients in Massachusetts vs low income and high income patients in ONES

"Massachusetts had the lowest response rate from 2001 to 2007 and for 2010, ranging from 34.6% to 47.7%."

In 2008 and 2009, Connecticut had the lowest response rate at 39.8% and 44.23% respectively

"The highest response rate was for Vermont in 2001 and from 2003 to 2010, ranging from 52.1% to 60.5%."

"In 2002 Maine had the highest response rate at 59.4%."

Data source: Population-based survey of adults in multiple states within the USA. (Behavioural Risk Factor Surveillance System (BRFSS)). "The BRFSS is a state-based survey … involves random-digit dialling (between 2001 and 2010 only landline numbers were included) and a random selection of one adult within that household to participate in a telephone survey."

Outcome measure:

Patient-level: self-reported: "Current smokers that tried to quit smoking in the past year"

  Parnes, 2002 [58]

Colorado, USA

59. Place innovation on fee for service lists/formularies

Cross-sectional study (with control group)

Analytical

Aged between 13–65 years

"Colorado Research Network (CaReNet) is a state-wide primary care, practice-based research network founded in 1997 with a particular focus on disadvantaged populations, including rural people, minorities, and the urban poor."

n = 7 primacy care practices in CaReNet in 1998 and 1999. (n = 4 family medicine residency sites, n = 2 federally-funded community health centers, n = 1 was clinic for the medically indigent.)

CaReNet providers completed NAMCS forms on 2,773 patient encounters of 2,800 eligible visits (99% completion rate) in 1998–1999. n = 1,443 patient visit records remained after excludions. "351 patients in the study sample (24%) were identified as smokers."

Data source: Physician survey (modified version of the 1994 National Ambulatory Medical Care Survey (NAMCS)). "The NAMCS instrument is a physician survey that collects information about an ambulatory visit." "Each CaReNet practice collected data on a total of 400 patient visits in 1-week cycles (100 patients per cycle), quarterly, for 1 year. We used the typical NAMCS protocol of collecting data on every second patient presenting for medical care during the study period."

Outcome measure:

"the key modification was the addition of “uninsured” in the Expected Source of Payment category. This category included patients who were in 1 of several programs that discount charges on the basis of income, thus covering some of the costs of care." "To identify patients with private insurance, the options “Private/commercial” and “HMO/other prepaid” were combined (“Private/HMO”)."

Practitioner-level:

"we examined the impact of patient insurance on 2 primary outcomes: (1) patient smoking status, and (2) whether smokers received smoking cessation counseling. Each provider coded smoking status as “Yes,” “No,” or “Unknown.” Only patients with a known smoking status (90% of sample) were included in the present analysis. For those patients coded as smokers, we determined whether providers checked the “Smoking Cessation” box."

  Tilson, 2004 [63]

Ireland

59. Place innovation on fee for service lists/formularies

Repeated cross-sectional study

Descriptive

Medical cardholders in Ireland, who are entitled to free prescriptions of certain medicines via the General Medical Services (GMS) scheme

In 2002: 29.84% of the population, n = 1,168,745 patients

Data source: National prescription database, General Medical Services (GMS) Payments Board prescription database

Outcome measure:

Practitioner-level: "Using the GMS Payments Board prescription database we conducted a detailed analysis of NRT prescribing (ATC code N07BA)" "the number of monthly prescriptions for each NRT preparation (ATC code N07BA01) and bupropion (ATC code N07BA02)" "Mean dosage, duration of therapy and age/gender distribution of NRT treatment was also obtained."

"NRT therapy formulations include gum, patches and inhaled medication."

  Williams, 2004 [64]

Ireland

59. Place innovation on fee for service lists/formularies

Repeated cross-sectional study

Descriptive

Medical cardholders in Ireland, who are entitled to free prescriptions of certain medicines via the General Medical Services (GMS) scheme, aged 16 years and over

January to December 2001: 31% of the Irish population, n = 919,326 patients

n = 8,166 patients were prescribed Buproprion, n = 18,450 patients were prescribed NRT

Data source: National prescription database, General Medical Services (GMS) Payments Board prescription database. the GMS population "cannot be regarded as representative of the general population as socially disadvantaged persons, children and the elderly are over represented, however, they receive about 70% of all medicines prescribed in Irish general practice."

Outcome measure:

Practitioner-level: "identified those patients who were prescribed Buproprion or NRT"

  Coleman, 2007 [32]

UK

60. Alter incentive/allowance structures

Repeated cross-sectional study

Analytical

Aged between 15–75 years. 1990 to 2005

1990: n = 776,302 patients

2000: n = 1,569,177 patients

2004: n = 1,607,782 patients

Data source: UK-representative primary care electronic healthcare records, THIN

Outcome measure:

Practitioner-level: "smoking status, recorded advice given to stop smoking and prescriptions for nicotine replacement therapy (NRT) or bupropion."

  Dhalwani, 2013 [38]

UK

60. Alter incentive/allowance structures

Repeated cross-sectional study

Descriptive

Pregnant women

January 2000 to December 2009: n = 277,552 pregnancies, n = 215,703 women with pregnancies resulting in live births or stillbirths

Data source: UK-representative primary care electronic healthcare records, THIN

Outcome measure:

Practitioner-level: "Records of maternal smoking status during pregnancy were identified using Read codes. These included codes for current, never, and ex-smoking, codes indicating the type or number of cigarettes smoked, and codes indicating smoking cessation interventions delivered to patients. Women were also considered to be smokers if they had a prescription for a smoking cessation drug (nicotine replacement therapy, bupropion or varenicline) in their medical records during pregnancy."

"The prevalence of smoking status recording during pregnancy was calculated for each year from 2000 to 2009 as the number of pregnancies with at least one recording of smoking status during the gestational period divided by the total number of pregnancies delivered in that year."

"Since April 2006 the QOF has not required GPs to record the smoking status of patients after the age of 25 years if they have been a never smoker until that age. After 2008, if a patient who once smoked has been recorded as an ex-smoker for three years, GPs need no longer check and update the patient's smoking status records. Therefore, we recalculated the proportion of pregnancies with missing gestational smoking status data to take these rules into account. For women who only had records of being a never smoker up to age 25 and who did not have a record of smoking during a subsequent pregnancy we imputed a never smoking record during gestation. Similarly, for women who had no smoking status records during gestation but who were recorded as ex-smokers for three consecutive years before the conception we imputed an ex-smoking record during gestation. We then recalculated the annual proportion of pregnancies with a recording of smoking status during the gestational period."

  Farley, 2017 [40]

UK

60. Alter incentive/allowance structures

Cohort study

Intervention group: Patients diagnosed with lung, bladder, or upper aerodigestive tract cancer between 1999–2013, had a record of smoking at diagnosis or within 3 years of diagnosis. n = 42,112 patients, n = 13,449 (32.0%) smoked at diagnosis, n = 3,092 (7.3%) had stopped smoking within 3 years of diagnosis

Control group: Matched patients with incident CHD diagnosed during the same period as control cases based on year of diagnosis, general practice, and smoking status. n = 159,182 patients, n = 28,987 (18.2%) smoked at diagnosis, n = 6,301 (4.0%) had stopped smoking within 3 years of diagnosis

Of these groups, n = 12,393 cancer patients were matched to n = 12,393 CHD control patients. (n = 9,347 patients with lung cancer (86% current smokers), n = 2,050 patients with bladder cancer (90% current smokers), n = 996 patients with upper aerodigestive tract cancers (91% current smokers).)

Data source: UK-representative primary care electronic healthcare records, CPRD

Outcome measure:

Practitioner-level and patient-level: "the proportion of current smokers and recent ex-smokers for whom their general practitioners updated smoking status, advised patients to stop or provided advice on how to do so, and prescribed cessation medication, as well as of patients who quit smoking during the year after diagnosis."

"We defined smoking at diagnosis as smoking on the last occasion smoking status was recorded in the 3 years before diagnosis. A recent ex-smoker was defined as someone recorded as smoking within 3 years of diagnosis and subsequently recorded as not smoking on the last occasion before diagnosis."

  Fichera, 2016 [45]

England

60. Alter incentive/allowance structures

Repeated cross-sectional study

Regression discontinuity design (with control)

"Sample of individuals reporting at least one condition incentivised by the QOF." 1997 to 2009

"The health conditions recorded in the HSE related to the seven disease areas targeted by the QOF are: cancer, diabetes, other endocrine problems, mental health, stroke, heart attack/angina, hypertension/high blood pressure, bronchitis, asthma, and other respiratory problems."

n = missing

Data source: Population-based survey of adults in England, "Health Survey for England (HSE) (1997–2009)." "The HSE comprises annual cross-sectional surveys beginning in 1991…. nationally representative of the English adult population with regard to age, gender, geographic area and socio-demographic circumstances. … use 12 years of data from 1997, after which income information was collected."

Outcome measure:

Practitioner-level:

"Smokers are asked whether they have been given smoking cessation advice by a medical practitioner and if so, whether such advice was delivered within the past 12 months. As the smoking cessation variable was not recorded in 2000, 2001 and 2002, we use a multiple imputation procedure to account for missing observations."

"The HSE contains information on the medicines that individuals have been prescribed."

Patient-level: "In each wave of the survey, respondents are asked whether they smoke and, if so, the average number of cigarettes smoked in a day. Non-smokers are coded as having zero consumption of cigarettes per day."

  Hardy, 2014 [39]

UK

60. Alter incentive/allowance structures

Repeated cross-sectional study

Descriptive

Pregnant women, aged 15–49 years at time of giving birth, smokers during pregnancy

2000 to 2009: n = 45,296 pregnancies, n = 39,781 women (classified as smokers during pregnancy) with pregnancies resulting in live births or stillbirths

n = 4,826 patients had NRT prescribed during pregnancy for smoking cessation

Data source: UK-representative primary care electronic healthcare records, THIN

Outcome measure:

Practitioner-level: "Women were defined as smokers if they had a Read code indicating smoking recorded in their medical records or a drug code for nicotine replacement therapy (NRT) during their pregnancy, or, in the absence of recording during pregnancy, if their last recorded Read code in the 27 months prior to pregnancy indicated smoking as defined in more detail previously."

"Across the whole study period, annual proportions of pregnant smokers with records of smoking cessation advice were calculated as the number of pregnancies among smokers with recorded smoking cessation advice divided by the total number of pregnancies among smokers who gave birth in that year."

  McGovern, 2008 [43]

Scotland

60. Alter incentive/allowance structures

Repeated cross-sectional study

Analytical

Patients with diagnosis of coronary heart disease (CHD), aged 16 years and over

Pre-contract (31 March 2004): n = 58,406 patients over 16 years had a computer record of CHD, 3.7% of the 1,578,902 registered individuals. n = 48 patients had a computer record of an exception code

Post-contract (31 March 2005): n = 75,495 of patients over 16 years had a computer record of CHD, 4.9% of the 1,533,802 registered individuals. n = 3,083 patients had a computer record of an exception code

Data source: Primary care electronic healthcare records: "Anonymized retrospective data from all 310 of the 850 Scottish practices who use the general practice administrative software system (GPASS) and who participate in Scottish Programme for Improving Clinical Effectiveness (SPICE) were obtained in November 2005." "previously been shown to be representative of the Scottish population."

Outcome measure:

Practitioner-level: "recording of smoking status and (where appropriate) provision of smoking cessation advice"

  Millett, 2007 [44]

UK

60. Alter incentive/allowance structures

Cohort study

Patients with diagnosis of Type 1 or Type 2 diabetes (had Read codes for diagnoses of diabetes (C10) or diabetes care (66A)), received repeat prescriptions for diabetic medications or had glycosylated hemoglobin level was greater than 7.5%, aged 18 years and over. Women with gestational diabetes or who received treatment for polycystic ovarian syndrome rather than diabetes were excluded

n = 32 practices out of 36 practices in the study area agreed to participate

n = 4,284 patients registered with the 32 practices in both the 2003 and 2005 study periods

Data source: Primary care electronic healthcare records: "Wandsworth Primary Care Trust, located in southwest London, England, has established comprehensive primary care-based diabetes registers."

Outcome measure:

Practitioner-level: "We examined smoking status and cessation advice based on information recorded on practice computers during the 2003 and 2005 study periods."

  Simpson, 2006 [49]

Scotland

60. Alter incentive/allowance structures

Repeated cross-sectional study

Analytical

Patients with diagnosis of transient ischaemic attack or stroke

Pre-contract (31 March 2004): n = 21,901 patients had a computer record of any stroke or TIA (1.2% of everyone registered with the practices). n = 46 patients had a computer record of an exception code

Post-contract (31 March 2005): n = 32,401 patients had a computer record of any stroke or TIA (1.8% of everyone registered with the practices). n = 2,565 had a computer record of an exception code

Data source: Primary care electronic healthcare records: "Anonymous retrospective data from all 310 of the 850 Scottish practices that use the General Practice Administrative Software System and that participate in SPICE were obtained in November 2005. These 310 practices were self-selected; however, they have been shown to be representative of all Scottish practices."

Outcome measure:

"From the accumulated data, we identified everyone who had a computer record of a TIA (read codes G65 to G654, G656 to G65zz) or stroke (including cerebral hemorrhagic; read codes G61 below but not G617, G66, and below) and nonhemorrhagic stroke (read codes G63y0-1, G6760, G6w, G6x, G64, and below) on March 31, 2004 (1 year before introduction of the new contract in April 2004, the “precontract” period in this article) and March 31, 2005 (1 year after introduction of the new contract in April 2004; the “postcontract” period). All registered patients with a recording of stroke before the 2 time points were included in the analyses."

Practitioner-level: "… smoking habits (current, ex-smoker, or never smoked) and (where appropriate) provision of smoking cessation advice…"

  Sutton, 2010 [47]

Scotland

60. Alter incentive/allowance structures

Repeated cross-sectional study

Analytical

Aged 45 years and over

Unit of analysis: each risk factor for each patient in each year. Within a year therefore, there are five observations for each patient. … Patients that are registered with a practice throughout all 6 years appear 30 (5 risk factors * 6 observation years) times."

2000 to 2005: n = 9,416,130 observations on 5 five risk factors for n = 391,323 individuals in each of up to 6 years

Data source: Primary care electronic healthcare records: Scottish Programme for Improving Clinical Effectiveness in Primary Care (SPICE-PC) data from 315 Scottish practices. "Participation in SPICE-PC is voluntary" "Participation in SPICE-PC was less likely in the most deprived areas and showed some geographical concentration. Compared with non-participants, participating practices had more patients in total (but fewer patients per GP), were more likely to also participate in other voluntary initiatives and achieved 1% more points on average on the 2005/6 QOF. This suggests some caution in extrapolating the results to all Scottish practices. However the differences on each variable are relatively small."

Outcome measure:

Practitioner-level: recording of risk factor: smoking status. "Practices could also earn additional points for recording that they had offered cessation advice to patients whose current smoking status had been established."

  Szatkowski, 2010 [29]

UK

60. Alter incentive/allowance structures

Repeated cross-sectional study

Descriptive

Aged 16 years and over. 1990 to 2006

1990: n = 56,595 patients across 103 practices

2006: n = 155,359 patients across 399 practices

Data source: UK-representative primary care electronic healthcare records, THIN

Outcome measure:

Practitioner-level: "We used the proportion of patients having their smoking status recorded within 90 days of registration as a proxy for smoking status being recorded at patient registration."

  Szatkowski, 2011 [28]

England

60. Alter incentive/allowance structures

Repeated cross-sectional study

Descriptive

Aged 16 years and over

THIN:

July 2000: n = 1.8 million patients aged 16 + registered with a THIN practice in England

July 2009: n = 2.0 million patients aged 16 + registered with a THIN practice in England

PCT Patient Survey, in England:

2004: n = 122,113 completed patient questionnaires, response rate: 47.4%

2005: n = 116,939 completed patient questionnaires, response rate: 45.4%

2008: n = 69,470 completed patient questionnaires, response rate: 38.3%

(a) Data source: UK-representative primary care electronic healthcare records, THIN

(a) Outcome measure: Practitioner-level: "…Read codes documenting the delivery of smoking cessation advice to that patient, and, for each year, the proportion of patients with a recording of cessation advice in the 12 months prior to the index date was calculated."

(b) Data source: Representative survey of primary care patients in England (PCT Patient Survey)

(b) Outcome measure: Practitioner-level: "postal questionnaire asked whether the respondent had ‘definitely’ or ‘to some extent’ received cessation advice from a health professional (GP or nurse) at their GP surgery within the last 12 months"

  Szatkowski, 2016 [27]

England

60. Alter incentive/allowance structures

Repeated cross-sectional study

Interrupted time series analysis (no control)

Aged 16 years and over. 2004 to 2013

n = 3,337,881 (SD 81,110) patients aged > 16 years registered in THIN each month, on average

n = 41,649 (SD 9,082) patients had a record of advice to quit each month, on average

n = 1,001 (SD 371) patients had a record of referral to the NHS Stop Smoking Service each month, on average

n = 9,921 (SD 1,851) patients had a prescription for a smoking cessation medication each month, on average

Data source: UK-representative primary care electronic healthcare records, THIN

Outcome measure:

Practitioner-level: "For each patient, Read Codes were used to identify whether they were advised to quit or referred to the NHS Stop Smoking Service in that month. Multilex drug codes were used to identify whether patients were prescribed a smoking cessation medication (NRT, bupropion, or varenicline) each month."

    Taggar, 2012 [30]

UK

60. Alter incentive/allowance structures

Repeated cross-sectional study

Descriptive

Aged over 15 years. 2000 to 2008

2002 (before QOF): n = 1,998,631 patients

2004 (at introduction of QOF): n = 2,053,840 patients

2008 (after QOF): n = 2,149,026 patients

Data source: UK-representative primary care electronic healthcare records, THIN

Outcome measure:

Practitioner-level: "…patients with a record of smoking status in the last 27 months and patients recorded as smokers with documented cessation advice in the last 15 months; patients were excluded from analysis if they had registered with a practice within the last three months, corresponding to the grace period GPs have to update the records of new patients (which includes the recording of smoking status)."

    Tahrani, 2007 [42]

England

60. Alter incentive/allowance structures

Repeated cross-sectional study

Analytical

Patients “on the diabetes register”

n = 2 Primary Care Trusts (PCTs) in Shropshire, England; made up of 66 practices

April 2004: n = 15,628 patients on the diabetes register

March 2005: n = 16,121 patients on the diabetes register

March 2006: n = 16,867 patients on the diabetes register

Data source: Primary care electronic healthcare records:

Pre-intervention measures: National Diabetes Audit, data generated by 65 of the 66 Shropshire GP practices

Post-intervention measures: data collected from 66 GP practices in Shropshire at March 2005 and March 2006

Outcome measure:

Practitioner-level: "the proportion of patients achieving each quality indicator ("smoking record", "smoking cessation advice") in each practice out of the total number of patients on the diabetes register in that practice"

  Donner-Banzhoff, 1996 [75]

Germany vs UK

65. Use capitated payments

Cross-sectional study (comparing two groups)

Analytical

Unspecified. Year unknown

n = 778 consecutive patients attending for a consultation. "8% of the patients approached declined to take part in the study."

Data source: Patient survey and subsequent patient interview. "A total of 15 family practitioners' surgeries in Germany and the UK that were matched for rural–urban location were included in a cross-sectional survey."

Outcome measure:

Practitioner-level: Consecutive patients attending for consultation were asked to complete a questionnaire. "They filled in a questionnnaire on sociodemographic data, medication, diagnoses, risk factor concepts, and remembered intervention against smoking. In the following interview, queries arising from the questionnaire could be addressed so as to keep the proportion of missing data low. Patients' records were analyzed for medication, laboratory tests, and previous contacts. During this study, interviews and examinations were performed by one researcher (NDB) in both countries."

"Whether a given patient could remember an intervention by his/her physician (or related staff) was defined as the main endpoint of the comparison. An intervention was assumed if the question "Has your family doctor ever talked to you about your smoking?" was answered by "yes" or if questions about possible interventions by doctor or nursing staff were answered in the affirmative. The questionnaire was developed simultaneously in German and English. It was then translated from English into German to correct linguistic ambiguities."

Categorisation of 'cessation interventions': 'None' or 'Advice once' or 'Advice several times' or 'Nicotine patch/gum' or 'Other'

Domain 9. Change infrastructure

  Szatkowski, 2021 [36]

England

66. Mandate change

Repeated cross-sectional study

Segmented regression analysis, no control

Pregnant women, aged 15–49 years at time of giving birth, smokers during pregnancy

2005 to 2017: n = 84,539 pregnancies where the mother was recorded as smoking, this was 24.9% of n = 339,875 all pregnancies

Data source: UK-representative primary care electronic healthcare records, CPRD

Outcome measure:

"Women were identified as smoking in pregnancy if they had a diagnostic code indicating current smoking, or a prescription for a smoking cessation medication, recorded at least once during gestation."

Practitioner-level: "Prescriptions for NRT were identified using relevant Multilex drug codes. Dual NRT was defined as prescription of a long-acting transdermal nicotine patch and a short-acting formulation (eg, gum, lozenge, inhalator, tablet, or spray) on the same day."

  Dhalwani, 2014 [41]

UK

69. Create or change credentialing and/or licensure standards

Repeated cross-sectional study

Descriptive

Pregnant women, aged 15–49 years at time of giving birth

2001 to 2012: n = 71,685 pregnancies which resulted in live births or still births, where the mother was classified as a smoker during pregnancy, this was 18.5% of n = 388,142 of all pregnancies which resulted in live births or stillbirths

Data source: UK-representative primary care electronic healthcare records, THIN

Outcome measure:

Practitioner-level: "The smoking status of females was determined using Read Codes recorded from 27 months before conception up to the end of pregnancy, based on the recording rules in the GP contract." "Multilex Drug Codes for all NRT formulations available in the UK according to the British National Formulary (BNF) were used for NRT prescriptions." "The use of different forms of NRT (patches, gum, nasal spray, lozenges, sublingual tablets, inhalator cartridges, and combination) was assessed."

  Langley, 2011 [34]

England

69. Create or change credentialing and/or licensure standards

Repeated cross-sectional study

Segmented regression analysis (no control)

Aged between 12–17 years. 2002 to 2009

n = missing

Data source: UK-representative primary care electronic healthcare records, THIN

Outcome measure:

Practitioner-level: "rates of prescribing of all NRT products per 100,000 adolescents registered with a THIN practice per month."

  Langley, 2012 [35]

England

69. Create or change credentialing and/or licensure standards

Repeated cross-sectional study

Segmented regression analysis (no control)

Aged over 16 years, had diagnosis of cardiovascular disease or stroke. 2002 to 2009

n = 88,000 coronary heart disease (CHD) patients each month

n = 39,000 stroke patients each month

Data source: UK-representative primary care electronic healthcare records, THIN

Outcome measure:

Practitioner-level: "the number of patients per 100,000 with CHD and stroke who received a prescription for NRT each month."

Extracted data on prescribing of NRT, varenicline and bupropion to CHD and stroke patients

  Li, 2020 [55]

United States (multi-state)

69. Create or change credentialing and/or licensure standards

Repeated cross-sectional study

Analytical

Aged between 55–80 years, smokers, no evidence of lung cancer. 2010 to 2017

n = 12,678 (63.8% of n = 19,862) current smokers were included in the analysis, whose eligibility for LDCT-LCS could be determined

Data source: Electronic healthcare records: from a "large healthcare system in northern California"

Outcome measure:

Practitioner-level: "Three types of smoking-cessation interventions (i.e., formal in-visit smoking-cessation counseling, informal smoking-cessation counseling or referrals to smoking-cessation programs, and medication orders for pharmacotherapy) were considered. … Keyword searches included but were not limited to, smoking cessation and tobacco counseling in the procedure description. Sessions of 3 − 10 min or > 10 min (e.g., billing codes: 99,406, G0375, G0376; 99,407, G0436, G0437, etc.) were classified as formal in-visit smoking-cessation counseling. Smoking-cessation counseling < 3 min is not separately billed; such unbilled in-visit smoking-cessation counseling, along with referrals for internal free smoking-cessation programs, are categorized as informal smoking-cessation counseling or referrals to smoking-cessation programs. Pharmacotherapy using smoking deterrents was identified by a prescription order for smoking-cessation medication, (e.g., bupropion HCl, varenicline tartrate, nicotine polacrilex, etc.)." "cigarettes smoked per day"

  Thorndike, 2007 [53]

United States (multi-state)

69. Create or change credentialing and/or licensure standards

Repeated cross-sectional study

Analytical

Aged 18 years and over

1994 to 1996: n = 84,104 adult patient visits to 4,118 physicians. Physician response rate: 71%

2001 to 2003: n = 58,991 adult patient visits to 2,902 physicians. Physician response rate: 67%

Difference between physician response rate is statistically significant (p = 0.001)

Data source: Physician survey, "The National Ambulatory Medical Care Survey (NAMCS) is an ongoing annual survey of US office-based physicians conducted by the National Center for Health Statistics."

"We compared pooled data from the 1994–1996 NAMCSs with data from the 2001–2003 surveys. … We were unable to examine these outcomes for the years 1997–2000 because the smoking status item was not included on the NAMCS in those years."

"Each participating physician completes a 1-page encounter form for each systematically sampled ambulatory care visit during a randomly assigned week."

Outcome measure:

Practitioner-level: "(1) Physicians identified a patient’s smoking status by answering the question, “Does patient use tobacco?” Smoking status was considered identified if the answer was “yes” or “no”; responses of “unknown” or left blank were considered not identified. (2) Physicians recorded smoking counseling by checking the “Tobacco use/exposure” box under “Counseling/Education.” (3) Prescription and nonprescription medications were recorded on the survey form under “Medications.”

All adult patient visits were included in the analysis of smoking status. Analyses of smoking counseling and smoking medications were restricted to visits by patients identified was smokers

Because bupropion is also used to treat depression, we excluded bupropion prescriptions prior to 1997, the year it was approved for smoking cessation."

  Peterson, 2016 [52]

United States (multi-state)

71. Change accreditation or membership requirements

Repeated cross-sectional study

Analytical

Patients “with hypertension”

n = 7,319 completed hypertension Performance in Practice Modules (PPMs) completed between 2006 and 2013, reflecting quality measures for between 80,000 and 160,000 patients, completed by eligible physicians (residing in the United States). "In 7.8% of the PPMs, physicians selected smoking cessation for improvement."

Data source: "We analyzed data from all hypertension Performance in Practice Modules (PPMs) completed from July 2006 to 2013." Patient health records: "diplomates gather quality measures from at least 10 patients with hypertension". Patient questionnaire: "patients complete a questionnaire"

Outcome measure:

"The PPM structure is based on a Plan-Do- Study-Act (PDSA) cycle. First, the physician, or assigned clinical staff, gathers data on 10 patients with hypertension from the chart and the corresponding patient survey data, and enters them on templates in the web-based PPM. [quality improvement exercise]…. After the physician implements their chosen interventions, collection of chart and survey data from the next 10 patients they see with a diagnosis of hypertension is repeated. After completion of data entry for this set of patients, the physician is provided with pre- and post-intervention comparisons as well as comparisons to the mean quality scores for all physicians who have previously completed the PPM."

Practitioner-level:

Patient records (physician-reported): Whether "smoking cessation counseling" was provided

Patients complete a questionnaire that includes: "(6) for smokers, whether your doctor asked about quitting"

  Shi, 2017 [59]

United States (multi-state)

71. Change accreditation or membership requirements

Cross-sectional study (with control group)

Analytical

Unspecified, aged 18 years and over, low income. 2012

n = 539 health centres (HCs) achieved 'Patient-centered medical home' (PCMH) recognition status

n = 548 HCs did not achieve PCMH recognition status

Data source: Provider survey/electronic records (Health Resources and Services Administration [HRSA] 2012 Uniform Data System (UDS) + HRSA’s Patient-Centered Medical/Health Home Initiative)

Outcome measure:

Practitioner-level: "percent of adults (18 years or older) assessed for tobacco use". "percent of adults (18 years or older) who were known tobacco users that received tobacco cessation counseling and/or pharmacologic intervention."

  Van Doorn-Klomberg, 2014 [68]

Netherlands

71. Change accreditation or membership requirements

Cohort study

Patients with diagnosis of diabetes mellitus, chronic obstructive pulmonary disease (COPD) or cardiovascular disease (CVD). 2006 to 2011

Matched sample: 1st cohort: n = 69 practices. 2006–2008: n = 4,629 average number of patients per practice. 2009–2011: n = 4,808 average number of patients per practice

Matched sample: 2nd cohort: n = 69 practices. 2009–2011: n = 4,830 average number of patients per practice

Data source: Primary care electronic healthcare records from Dutch primary care practices that participated in the accreditation program of the Dutch College of General Practitioners between 2006 and 2011

Outcome measure:

Patient-level:

Patients with COPD and Patients with CVD: "Percentage of patients that smoke"

Practitioner-level: "Percentage of patients with a known smoke status",

"Percentage of patients that smoke with a stop smoking advice"

Multiple domains

  Akman, 2017 [72]

Turkey

Domain 8

65. Use capitated payments

AND

Domain 9

66. Mandate change, 67. Change record systems, 71. Change accreditation or membership requirements

Repeated cross-sectional study

Analytical

Unspecified patient population

1993: n = 199 primary care doctors (response rate: 50%), "doctors working in inner city and urban areas were over-represented"

2012: n = 299 primary care doctors (response rate: 42.9%)

Data source:

1993: Primary care doctor survey: 1993 European GP Task Profile study. "In 1993, the study sample included a random sample of PCDs in 10 preselected provinces out of all 74 provinces in Turkey"

2012: Primary care doctor survey: 2012 Quality and Costs of Primary Care in Europe (QUALICOPC) study. "In 2012, data was collected from seven provinces of Turkey. Selection of provinces was based on the year the FD scheme was introduced, and the geographical distribution within the country. A quota of 10% per region was applied for all PCDs with family medicine specialist qualifications working in the region."

Outcome measure:

Practitioner-level: self-reported proportion of "primary care doctors who are usually or almost always involved in given preventive care service (smoking counselling during outpatient clinic)". "The questions in the 1993 survey on GP service profiles were repeated in 2012 with the purpose of comparing general practice between the two time points."

  Bailey, 2017 [50]

Oregon, USA

Domain 8

60. Alter incentive/allowance structures

AND

Domain 9

67. Change record systems

Repeated cross-sectional study

Analytical

Aged 18 years and over, excludes pregnant patients. "Most are uninsured or Medicaid recipients and have disproportionately high rate of smoking compared with patients seen in private primary care clinics". 2010 to 2014

2010: n = 55,398 patients

2012: n = 60,610 patients

2014: n = 66,712 patients

Data source: Primary care electronic healthcare records (Oregon Community Health Information Network, “OCHIN, Inc.”): 26 Oregon community health centers (CHCs))(federally qualified heath centers that are subsidized to serve low-income and vulnerable populations) that were using OCHIN’s EHR before 1 July 2009 were extracted

Outcome measure:

Practitioner-level and patient-level:

"The denominator for smoking status assessment included all study patients within a measurement year; the denominator for all other outcomes included patients identified as smokers within a measurement year."

(1) "Smoking status was considered to be assessed if changes were made to the discrete data field with drop-down options for smoking status (located in both the vital signs and social history in all study years), if the button was selected to confirm that smoking status was reviewed, or if a status was captured via NLP in the free-text notes within the measurement year

(2) A patient was identified as a current smoker if smoking status in the discrete data field was “current every day,” “current some day,” “smoker, current status unknown,” “heavy tobacco smoker,” or “light tobacco smoker.”"

(3) "Receipt of counseling was deemed “yes” if the discrete field, “counseling given,” was coded as “yes,” if identified by standard procedure codes for smoking-cessation counseling or an internal OCHIN Epic code for counseling referral, or if any statements in the free-text fields about smoking and cessation (e.g., goals, triggers, efforts) were identified."

(4) "Smoking-cessation medication orders (bupropion, varenicline, and all nicotine-replacement therapy products) were extracted from the medication orders list

(5) “medications ordered or discussed”: included orders or any discussion of cessation medications as captured in the free text via NLP

  Fortmann, 2020 [56]

United States (multi-state)

Domain 8

60. Alter incentive/allowance structures

AND

Domain 9

71. Change accreditation or membership requirements

Cohort study

Interrupted time series analysis (no control)

Aged 18 years and over. "72% of patients were members of ethnic and racial minority groups and 73% reported incomes below the Federal Poverty Level (FPL)." 2006–2013

n = 9 US states, 15 community health centres (CHCs), 706,840 patients. (Average CHC size: 4,700 to 67,000 patients.)

Data source: Electronic healthcare records (Community Health Applied Research Network (CHARN)—data from 15 community health centres, across 9 US states)

Outcome measure:

Practitioner-level: "structured EMR data (not free text) on smoking status and patient characteristics from the 15 CHCs with smoking data beginning either in 2006 or in the earliest year in which data were recorded." "Overall rates of documentation were assessed for each year from 2006 to 2013 at the clinic level (the denominator increased as clinics were added to the database)." "Smoking status was recorded as current, former, never, or unknown/missing. The EMRs in this study carried forward smoking status from previous visits to inform clinical staff of prior smoking status, which could then be reviewed and changed if necessary. If the smoking status was unchanged, this was often not specifically noted. …if no smoking status was recorded in a given year, status was set as that of the last recorded value. Thus, missing/unknown smoking status indicated that providers had never recorded smoking status for a given individual."

  Langley, 2011 [37]

England

Domain 8

59. Place innovation on fee for service lists/formularies

AND

Domain 9

69. Create or change credentialing and/or licensure standards

Repeated cross-sectional study

Interrupted time series analysis (no control)

Unspecified, "all primary care patients registered". 2000–2009

n = missing. "Prescribing of varenicline increased most markedly in July 2007, growing to around 100 prescriptions per 100,000 population, and remained around this higher rate for the rest of the study period."

Data source: UK-representative primary care electronic healthcare records, THIN

Outcome measure:

Practitioner-level: "monthly rates of general practice prescribing for each of NRT, bupropion and varenicline and all smoking cessation medications combined."

  Mullins, 2009 [51]

Delaware, USA

Domain 5

40. Distribute educational materials

42. Conduct educational meetings

AND

Domain 7

54. Prepare patients/consumers to be active participants

Repeated cross-sectional study

Analytical

Unspecified, "all [primary care] patients". "Patients without a recorded smoking history were excluded." 2006 to 2008

Pre-intervention group (office visit between 1 July 2006 and 1 January 2007): n = 922 patients

Post-intervention group (office visit between 1 July 2007 and 1 January 2008): n = 3,154 patients

Data source: Primary care electronic healthcare records from Family Medicine Center of Christiana Care Health System. "… suburban outpatient office in Wilmington, Delaware", USA

Outcome measure:

Practitioner-level and patient-level: "The number of patients recorded as current smokers and the number of patients counseled to quit by their physician…"

"Smokers were defined as patients who had an EMR flow sheet value for “smoking status” that read “current.” Patients were defined as nonsmokers if smoking status flow sheet values were “quit,” “never,” or if no value was recorded

"Tobacco cessation counselling", "patient had at some time been counseled to quit smoking by their provider": Patients were defined as having been counseled to quit smoking if the flow sheet value for “advised to quit” was ever recorded as “yes.”"

"The inquiry to determine the preintervention group was “Find Patients where Home Location is 'FMC' AND Date of Last Office Visit is on or after '07/01/2006' AND Date of Last Office Visit is before '01/01/2007' AND SMOK STATUS (any entry) contains 'current' AND SMOK ADVICE (last entry) contains 'yes'.” The inquiry to determine the postintervention group was the same, with visits on or after July 1, 2007, and before January 1, 2008."

  Verbiest, 2013 [67]

Netherlands

Domain 8

59. Place innovation on fee for service lists/formularies

AND

Domain 9

69. Create or change credentialing and/or licensure standards

Repeated cross-sectional study

Interrupted time series analysis (no control) (of three nation-wide representative databases)

Unspecified, adults (aged 15 years and over)

Netherlands Information Network of Primary Care (LINH): representative sample of 84 general practices with approximately 350,000 listed patients. 2001 to 2011

Dutch Foundation for Pharmaceutical Statistics (SFK): representative panel of 95% of Dutch community pharmacies. 2001 to 2012

Dutch Continuous Survey of Smoking Habits (DCSSH): representative of Dutch adult population (15 years and older). 2001 to 2012

(a) Data source: Nation-wide general practice electronic health records (Netherlands Information Network of Primary Care (LINH)). "The characteristics of the study population (GPs and patients) are comparable with the general Dutch population in terms of age and gender."

(a) Outcome measure:

Practitioner-level: "number of quarterly prescribed stop-smoking medications in general practice… "prescriptions of NRT, varenicline and bupropion in the period 2001–2011 and calculated prescription rates per 1000 smokers. …. The number of smokers was based on the total population and smoking prevalence."

(b) Data source: Nation-wide prescription database (Dutch Foundation for Pharmaceutical Statistics (SFK)). "The SFK gathers data from a representative panel of 95% of Dutch community pharmacies. Data were extrapolated to nation-wide figures."

(b) Outcome measure:

Practitioner-level: "prescriptions of stop-smoking medication dispensed in out-patient pharmacies". "dispensations of NRT, varenicline and bupropion in the period 2001–2012 and calculated dispensed rates per 1000 smokers."

For bupropion: **"primary care prescriptions (a) in this study represent the total number of prescriptions for both depression and quit smoking and the dispensed items (b) represent only stop-smoking medication"

For varenicline: "We did not assess the impact of the GP guideline introduction on the number of primary care prescriptions and dispensed prescriptions of varenicline because this pharmaceutical was introduced in the Netherlands around the same time as the GP guideline (December 2006)."

"we only assessed the immediate effect of the introduction and abolition of the insurance coverage in (dispensed) prescriptions and smoking prevalence, as we lacked sufficient time-points to estimate a change in trend."

(c) Data source: Population-based survey of adults in the Netherlands (Dutch Continuous Survey of Smoking Habits (DCSSH)). "The DCSSH assesses smoking behaviour of the Dutch adult population (15 years and older)." Representative; weightings based on gender, age, education level, socioeconomic status, the province in which they lived, and their family and community size

(c) Outcome measure:

Patient-level: "Smoking prevalence (2001–2012) was assessed by asking participants ‘Do you (ever) smoke?’."