Increased awareness enhances physician recognition of the role of smoking in chronic pancreatitis

Thiruvengadam Muniraj, Dhiraj Yadav, Judah N. Abberbock, Samer Alkaade, Stephen T. Amann, Michelle A. Anderson, Peter A. Banks, Randall E. Brand, Darwin Conwell, Gregory A. Cote, Christopher E. Forsmark, Timothy B. Gardner, Andres Gelrud, Nalini Guda, Michele D. Lewis, Joseph Romagnuolo, Bimaljit S. Sandhu, Stuart Sherman, Vikesh K. Singh, Adam Slivka & 3 others Gong Tang, David C. Whitcomb, C. Mel Wilcox

Research output: Contribution to journalArticle

Abstract

Background: We have previously reported that physicians under-recognize smoking as a chronic pancreatitis (CP) risk factor. We hypothesized that availability of empiric data will influence physician recognition of this relationship. Methods: We analyzed data from 508 CP patients prospectively enrolled in the North American Pancreatitis Study-2 Continuation and Validation (NAPS2-CV) or NAPS2-Ancillary (AS) studies (2008–2014) from 26 US centers who self-reported ever-smoking. Information on smoking status, physician-defined etiology and identification of smoking as a CP risk factor was obtained from structured patient and physician questionnaires. We compared how often physician identified smoking as a CP risk factor in NAPS2-CV/NAPS2-AS studies with NAPS2-original study (2000–2006). Results: Enrolling physician identified smoking as a risk factor in significantly (all p < 0.001) greater proportion of patients in NAPS2-CV/AS studies when compared with NAPS2-original study among ever (80.7 vs. 45.3%), current (91.3 vs. 53%), past (60.3 vs. 30.2%) smokers, in those who smoked ≤1 pack/day (79.3 vs. 39.5%) or ≥1 packs/day (83 vs. 49.8%). In multivariable analyses, the enrolling physician was 3.32–8.49 times more likely to cite smoking as a CP risk factor in the NAPS2-CV/NAPS2-AS studies based on smoking status and amount after controlling for age, sex, race and alcohol etiology. The effect was independent of enrolling site in a sub-analysis limited to sites participating in both phases of enrollment. Conclusions: Availability of empiric data likely enhanced physician recognition of the association between smoking and CP. Wide-spread dissemination of this information could potentially curtail smoking rates in subjects with and those at risk of CP.

Original languageEnglish (US)
JournalPancreatology
DOIs
StatePublished - Jan 1 2019

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Physician's Role
Chronic Pancreatitis
Smoking
Physicians
Information Dissemination
Pancreatitis
Alcohols

Keywords

  • Etiology
  • Pancreatitis
  • Risk factor
  • Smoking

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Hepatology
  • Gastroenterology

Cite this

Muniraj, T., Yadav, D., Abberbock, J. N., Alkaade, S., Amann, S. T., Anderson, M. A., ... Wilcox, C. M. (2019). Increased awareness enhances physician recognition of the role of smoking in chronic pancreatitis. Pancreatology. https://doi.org/10.1016/j.pan.2019.02.009

Increased awareness enhances physician recognition of the role of smoking in chronic pancreatitis. / Muniraj, Thiruvengadam; Yadav, Dhiraj; Abberbock, Judah N.; Alkaade, Samer; Amann, Stephen T.; Anderson, Michelle A.; Banks, Peter A.; Brand, Randall E.; Conwell, Darwin; Cote, Gregory A.; Forsmark, Christopher E.; Gardner, Timothy B.; Gelrud, Andres; Guda, Nalini; Lewis, Michele D.; Romagnuolo, Joseph; Sandhu, Bimaljit S.; Sherman, Stuart; Singh, Vikesh K.; Slivka, Adam; Tang, Gong; Whitcomb, David C.; Wilcox, C. Mel.

In: Pancreatology, 01.01.2019.

Research output: Contribution to journalArticle

Muniraj, T, Yadav, D, Abberbock, JN, Alkaade, S, Amann, ST, Anderson, MA, Banks, PA, Brand, RE, Conwell, D, Cote, GA, Forsmark, CE, Gardner, TB, Gelrud, A, Guda, N, Lewis, MD, Romagnuolo, J, Sandhu, BS, Sherman, S, Singh, VK, Slivka, A, Tang, G, Whitcomb, DC & Wilcox, CM 2019, 'Increased awareness enhances physician recognition of the role of smoking in chronic pancreatitis', Pancreatology. https://doi.org/10.1016/j.pan.2019.02.009
Muniraj, Thiruvengadam ; Yadav, Dhiraj ; Abberbock, Judah N. ; Alkaade, Samer ; Amann, Stephen T. ; Anderson, Michelle A. ; Banks, Peter A. ; Brand, Randall E. ; Conwell, Darwin ; Cote, Gregory A. ; Forsmark, Christopher E. ; Gardner, Timothy B. ; Gelrud, Andres ; Guda, Nalini ; Lewis, Michele D. ; Romagnuolo, Joseph ; Sandhu, Bimaljit S. ; Sherman, Stuart ; Singh, Vikesh K. ; Slivka, Adam ; Tang, Gong ; Whitcomb, David C. ; Wilcox, C. Mel. / Increased awareness enhances physician recognition of the role of smoking in chronic pancreatitis. In: Pancreatology. 2019.
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title = "Increased awareness enhances physician recognition of the role of smoking in chronic pancreatitis",
abstract = "Background: We have previously reported that physicians under-recognize smoking as a chronic pancreatitis (CP) risk factor. We hypothesized that availability of empiric data will influence physician recognition of this relationship. Methods: We analyzed data from 508 CP patients prospectively enrolled in the North American Pancreatitis Study-2 Continuation and Validation (NAPS2-CV) or NAPS2-Ancillary (AS) studies (2008–2014) from 26 US centers who self-reported ever-smoking. Information on smoking status, physician-defined etiology and identification of smoking as a CP risk factor was obtained from structured patient and physician questionnaires. We compared how often physician identified smoking as a CP risk factor in NAPS2-CV/NAPS2-AS studies with NAPS2-original study (2000–2006). Results: Enrolling physician identified smoking as a risk factor in significantly (all p < 0.001) greater proportion of patients in NAPS2-CV/AS studies when compared with NAPS2-original study among ever (80.7 vs. 45.3{\%}), current (91.3 vs. 53{\%}), past (60.3 vs. 30.2{\%}) smokers, in those who smoked ≤1 pack/day (79.3 vs. 39.5{\%}) or ≥1 packs/day (83 vs. 49.8{\%}). In multivariable analyses, the enrolling physician was 3.32–8.49 times more likely to cite smoking as a CP risk factor in the NAPS2-CV/NAPS2-AS studies based on smoking status and amount after controlling for age, sex, race and alcohol etiology. The effect was independent of enrolling site in a sub-analysis limited to sites participating in both phases of enrollment. Conclusions: Availability of empiric data likely enhanced physician recognition of the association between smoking and CP. Wide-spread dissemination of this information could potentially curtail smoking rates in subjects with and those at risk of CP.",
keywords = "Etiology, Pancreatitis, Risk factor, Smoking",
author = "Thiruvengadam Muniraj and Dhiraj Yadav and Abberbock, {Judah N.} and Samer Alkaade and Amann, {Stephen T.} and Anderson, {Michelle A.} and Banks, {Peter A.} and Brand, {Randall E.} and Darwin Conwell and Cote, {Gregory A.} and Forsmark, {Christopher E.} and Gardner, {Timothy B.} and Andres Gelrud and Nalini Guda and Lewis, {Michele D.} and Joseph Romagnuolo and Sandhu, {Bimaljit S.} and Stuart Sherman and Singh, {Vikesh K.} and Adam Slivka and Gong Tang and Whitcomb, {David C.} and Wilcox, {C. Mel}",
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T1 - Increased awareness enhances physician recognition of the role of smoking in chronic pancreatitis

AU - Muniraj, Thiruvengadam

AU - Yadav, Dhiraj

AU - Abberbock, Judah N.

AU - Alkaade, Samer

AU - Amann, Stephen T.

AU - Anderson, Michelle A.

AU - Banks, Peter A.

AU - Brand, Randall E.

AU - Conwell, Darwin

AU - Cote, Gregory A.

AU - Forsmark, Christopher E.

AU - Gardner, Timothy B.

AU - Gelrud, Andres

AU - Guda, Nalini

AU - Lewis, Michele D.

AU - Romagnuolo, Joseph

AU - Sandhu, Bimaljit S.

AU - Sherman, Stuart

AU - Singh, Vikesh K.

AU - Slivka, Adam

AU - Tang, Gong

AU - Whitcomb, David C.

AU - Wilcox, C. Mel

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background: We have previously reported that physicians under-recognize smoking as a chronic pancreatitis (CP) risk factor. We hypothesized that availability of empiric data will influence physician recognition of this relationship. Methods: We analyzed data from 508 CP patients prospectively enrolled in the North American Pancreatitis Study-2 Continuation and Validation (NAPS2-CV) or NAPS2-Ancillary (AS) studies (2008–2014) from 26 US centers who self-reported ever-smoking. Information on smoking status, physician-defined etiology and identification of smoking as a CP risk factor was obtained from structured patient and physician questionnaires. We compared how often physician identified smoking as a CP risk factor in NAPS2-CV/NAPS2-AS studies with NAPS2-original study (2000–2006). Results: Enrolling physician identified smoking as a risk factor in significantly (all p < 0.001) greater proportion of patients in NAPS2-CV/AS studies when compared with NAPS2-original study among ever (80.7 vs. 45.3%), current (91.3 vs. 53%), past (60.3 vs. 30.2%) smokers, in those who smoked ≤1 pack/day (79.3 vs. 39.5%) or ≥1 packs/day (83 vs. 49.8%). In multivariable analyses, the enrolling physician was 3.32–8.49 times more likely to cite smoking as a CP risk factor in the NAPS2-CV/NAPS2-AS studies based on smoking status and amount after controlling for age, sex, race and alcohol etiology. The effect was independent of enrolling site in a sub-analysis limited to sites participating in both phases of enrollment. Conclusions: Availability of empiric data likely enhanced physician recognition of the association between smoking and CP. Wide-spread dissemination of this information could potentially curtail smoking rates in subjects with and those at risk of CP.

AB - Background: We have previously reported that physicians under-recognize smoking as a chronic pancreatitis (CP) risk factor. We hypothesized that availability of empiric data will influence physician recognition of this relationship. Methods: We analyzed data from 508 CP patients prospectively enrolled in the North American Pancreatitis Study-2 Continuation and Validation (NAPS2-CV) or NAPS2-Ancillary (AS) studies (2008–2014) from 26 US centers who self-reported ever-smoking. Information on smoking status, physician-defined etiology and identification of smoking as a CP risk factor was obtained from structured patient and physician questionnaires. We compared how often physician identified smoking as a CP risk factor in NAPS2-CV/NAPS2-AS studies with NAPS2-original study (2000–2006). Results: Enrolling physician identified smoking as a risk factor in significantly (all p < 0.001) greater proportion of patients in NAPS2-CV/AS studies when compared with NAPS2-original study among ever (80.7 vs. 45.3%), current (91.3 vs. 53%), past (60.3 vs. 30.2%) smokers, in those who smoked ≤1 pack/day (79.3 vs. 39.5%) or ≥1 packs/day (83 vs. 49.8%). In multivariable analyses, the enrolling physician was 3.32–8.49 times more likely to cite smoking as a CP risk factor in the NAPS2-CV/NAPS2-AS studies based on smoking status and amount after controlling for age, sex, race and alcohol etiology. The effect was independent of enrolling site in a sub-analysis limited to sites participating in both phases of enrollment. Conclusions: Availability of empiric data likely enhanced physician recognition of the association between smoking and CP. Wide-spread dissemination of this information could potentially curtail smoking rates in subjects with and those at risk of CP.

KW - Etiology

KW - Pancreatitis

KW - Risk factor

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