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; Gong Tang; David C. Whitcomb; C. Mel Wilcox

doi:10.1016/j.pan.2019.02.009

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 SlivkaGong Tang, David C. Whitcomb, C. Mel Wilcox

Research output: Contribution to journal › Article › peer-review

8 Scopus citations

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 language	English
Pages (from-to)	500-506
Number of pages	7
Journal	Pancreatology
Volume	19
Issue number	4
DOIs	https://doi.org/10.1016/j.pan.2019.02.009
State	Published - Jun 2019

Bibliographical note

Publisher Copyright:
© 2019

Funding

This research was supported by the National Institute of Health under award numbers DK061451 (DCW), DK077906 (DY), UO1 DK108327 (DC), UO1 DK108320 (CEF), U01 DK108306 (DCW, DY), and UL1 RR024153 and UL1TR000005 (PI—Steven E Reis, MD). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. This research was supported by the National Institute of Health under award numbers DK061451 (DCW), DK077906 (DY), UO1 DK108327 (DC), UO1 DK108320 (CEF), U01 DK108306 (DCW, DY), and UL1 RR024153 and UL1TR000005 (PI?Steven E Reis, MD). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. This study was presented as a Poster at the Digestive Disorders Week 2015 and published in an abstract form in Gastroenterology April 2015, Vol 148, Supp 1, Page S-909 as ?Increased Awareness Enhances Physician Recognition of the Role of Smoking on Chronic Pancreatitis (CP).?, The authors acknowledge the Epidemiology Data Center, Michael O'Connell, PhD Division of Gastroenterology & Hepatology at the University of Pittsburgh for data management of NAPS2 studies, Kim Stello and Danielle Dwyer for genotyping and laboratory management, John Baillie MD, Department of Medicine, Virginia Commonwealth University, Richmond, VA and other members of the NAPS2 consortium. Affiliation of authors during patient recruitment were ?John Baillie (Duke University, Durham, NC), Darwin Conwell (Brigham & Women's Hospital, Boston, MA), Gregory A Cote (Indiana University, Indianapolis, IN), Andres Gelrud (University of Pittsburgh Medical Center, Pittsburgh, PA and University of Chicago, Chicago, IL), Thiruvengadam Muniraj (Griffin Hospital, Yale University affiliate, New Haven, CT), Joseph Romagnuolo (Medical University of South Carolina, Charleston, SC), Bimaljit S Sandhu (Virginia Commonwealth University, Richmond VA).

Funders	Funder number
National Institute of Health National Institute of Minority and Health Disparities Loan Repayment Program	UO1 DK108320, UO1 DK108327, UL1TR000005, DK061451, U01 DK108306, DK077906, UL1 RR024153
National Institutes of Health (NIH)
National Institute of Diabetes and Digestive and Kidney Diseases	R01DK077906
National Institute of Diabetes and Digestive and Kidney Diseases
Yale University
University of Southern Indiana
The University of Chicago
Virginia Commonwealth University

Keywords

Etiology
Pancreatitis
Risk factor
Smoking

ASJC Scopus subject areas

Endocrinology
Endocrinology, Diabetes and Metabolism
Hepatology

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.pan.2019.02.009

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Muniraj, T., Yadav, D., Abberbock, J. N., Alkaade, S., Amann, S. T., Anderson, M. A., Banks, P. A., Brand, R. E., Conwell, D., Cote, G. A., Forsmark, C. E., Gardner, T. B., Gelrud, A., Guda, N., Lewis, M. D., Romagnuolo, J., Sandhu, B. S., Sherman, S., Singh, V. K., ... Wilcox, C. M. (2019). Increased awareness enhances physician recognition of the role of smoking in chronic pancreatitis. Pancreatology, 19(4), 500-506. https://doi.org/10.1016/j.pan.2019.02.009

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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}",

note = "Publisher Copyright: {\textcopyright} 2019",

year = "2019",

month = jun,

doi = "10.1016/j.pan.2019.02.009",

language = "English",

volume = "19",

pages = "500--506",

journal = "Pancreatology",

issn = "1424-3903",

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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, vol. 19, no. 4, pp. 500-506. https://doi.org/10.1016/j.pan.2019.02.009

TY - JOUR

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 - 2019/6

Y1 - 2019/6

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

KW - Smoking

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DO - 10.1016/j.pan.2019.02.009

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VL - 19

SP - 500

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JO - Pancreatology

JF - Pancreatology

IS - 4

ER -

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

Abstract

Bibliographical note

Funding

Keywords

ASJC Scopus subject areas

UN SDGs

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