Text Messaging for Supporting Quit Attempts

Study Overview
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Brief Summary
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This study is a preliminary research aimed to compare the feasibility and effectiveness of motivational interview (MI), Personalized text messages (TM) and usual care for outpatients, with focus on smoking cessation as the main outcome. Smokers patients have received brief interventions and nicotine replacement therapy during the hospitalization. After discharge smokers were allocated into a intervention or control arm. In the first and third months, after randomization, the patients were contact to smoke abstinence assessment.

Detailed Description
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Background: Research suggests that smokers who receive treatment inside the hospital and post-discharge follow up for at least a month are more likely to quit smoking than those who didn't receive any intervention. The current challenge is to know the best way to support post-discharge quit attempts in the Brazilian context. Objective: The aim of this study was to compare the feasibility and effectiveness of motivational interview (MI) plus Personalized text messages (TM) and usual care for support smoking cessation among post-discharge patients. Methods: All patients admitted to the University Hospital of Juiz de Fora (HU/UFJF), between 06/2015 to 01/2016, were asked about the cigarettes consumption in the last 30 days. Smokers patients received brief interventions and nicotine replacement therapy during the hospitalization. After hospitalization discharge smokers were allocated into a intervention or control arm. The intervention group received a singular MI session by phone and mobile phone TM twice a day during eight or fifteen days. The control group received only usual care available inside the hospital. Results: At the first and third months, after randomization, the patients were contacted for smoke abstinence assessment.

Official Title
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Telephone Counseling and Text Messaging for Supporting Post-discharge Quit Attempts Among Hospitalized Smokers in Brazil

Conditions
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Tobacco Use Cessation, Tobacco Use Disorder

Intervention / Treatment
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* Behavioral: Motivational Interview plus text message


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Aged 18 years or older Smoked cigarettes in the last 30 days (even a puff) Have own mobile phone Have received at least one text message in the last year Have no problem with the mobile phone signal Exclusion Criteria: Don't have a mobile phone Unstable cognitive or physical condition Physical or breath contact restrictions Intensive care units

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Motivational Interview plus text message<br>Inside the hospital: All participants have received the written materials. Patients with high tobacco dependence (Fagerstrom screening test score 5 or higher) have received also Nicotine Replacement Therapy (NRT). The written materials provided information on benefits of quitting and strategies for a successful quit plan, including information on relapse prevention. Post discharge extended treatment: Participants in this arm have received a telephone counseling session using a motivational interviewing approach and fifteen or eight days of text messages. The timing, duration, and content of the counseling session were consistent with guideline-based recommendations. | Behavioral: Motivational Interview plus text message<br>* After discharge the experimental group has received extended care including a counseling session and text messages. The session provided basic information about smoking and successful quitting. The counselor has used motivational interview techniques to build coping skills with the goal of helping the participant build and implement a quit plan. The focus was to increase motivation to make quit attempt, including confidence building, medication use, and cessation planning. The session lasted approximately 30 minutes. Participants in the experimental arm were offered up to 30 text messages to help them to implement the quit plan discussed during the phone call. Patients motivated to quit in the next 30 days or those that had already quit have received 30 messages (2 per day) and patients unwilling to quit 16 (2 per day). The messages followed the self efficacy theory.<br>|
| No Intervention: Control Arm<br>Inside the hospital: All participants have receive the written materials. Patients with high tobacco dependence (Fagerstrom screening test score 5 or higher) have received also Nicotine Replacement Therapy (NRT). The written materials provided information on benefits of quitting and strategies for a successful quit plan, including information on relapse prevention. Post discharge extended care: None | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Self Reported Smoking Abstinence | No smoking (even a puff) in the past 7 days at the first month follow up. | Smoking abstinence at the first month after randomization | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Daily Cigarettes Consumption at 3 Months Among Continuing Smokers | The experimental group self reported daily cigarettes consumption at the third month after randomization with be compared to the control group. | At the third month after randomization | 
| Self Reported Seek for Specialized Tobacco Treatment | self reported seek for specialized tobacco treatment after hospitalization | at the third month after randomization | 
| Self Reported Smoking Abstinence | No smoking (even a puff) in the past 7 days at the third month after randomization. | Smoking abstinence at the third month after randomization | 
| Carbon Monoxide Verified Smoking Abstinence | Carbon Monoxide verified Smoking Abstinence at third-month follow up. Abstinence defined as Carbon Monoxide ≤ 6. | At third-month follow up | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Tobacco Use Disorder, Hospitalized patients, Motivational Interview, Substance-Related Disorders, Behaviors and Mental Disorders, Text message