Clinical trial NCT00057070: Facilitating Implementation of the PHS Smoking Cessation Guidelines - RESET
Official title: Facilitating Implementation of the PHS Smoking Cessation Guidelines - RESET
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Smoking Cessation
Randomized Controlled Trial
Lead sponsor: VA Office of Research and Development
Sponsor class: FED
First posted: 2003-03-28
Enrollment: 1900
Sex: ALL
Minimum age (years): 19
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: SINGLE_GROUP

Brief summary: The adverse impact of tobacco use on disease prevalence and health care costs is well documented. Hence, finding effective ways to reduce tobacco dependence is an essential component of improving the outcomes, quality and efficiency of VHA care. The U.S. Public Health Service (PHS) Smoking Cessation Clinical Practice Guideline provides specific recommendations for treating tobacco dependence. Despite their strong evidence base, however, these recommendations have not been fully integrated into clinical practice within the VHA. Recent data suggest that logistical difficulties associated with identifying and linking smokers with appropriate treatments may explain why the PHS Smoking Cessation Guideline has not been more broadly implemented.

Detailed description: Background:

The adverse impact of tobacco use on disease prevalence and health care costs is well documented. Hence, finding effective ways to reduce tobacco dependence is an essential component of improving the outcomes, quality and efficiency of VHA care. The U.S. Public Health Service (PHS) Smoking Cessation Clinical Practice Guideline provides specific recommendations for treating tobacco dependence. Despite their strong evidence base, however, these recommendations have not been fully integrated into clinical practice within the VHA. Recent data suggest that logistical difficulties associated with identifying and linking smokers with appropriate treatments may explain why the PHS Smoking Cessation Guideline has not been more broadly implemented.

Objectives:

The primary objective of this study is to assess the effectiveness of an intervention for increasing the rate of tobacco dependence treatment in a population of smokers identified through the VA Pharmacy Benefits Management database. Secondary objectives of this study include (1) assessing the effect of the intervention on smoking cessation rates, and (2) developing options for overcoming potential barriers to broad implementation of the strategies.

Methods:

The effectiveness of the intervention will be evaluated using a multi-center, randomized, controlled trial. Veterans receiving a prescription for transdermal nicotine, nicotine gum, or bupropion for smoking cessation in the past year at one of the participating VHA facilities (as determined from Pharmacy Benefits Management records) will be eligible for the study. A total of 1,900 eligible veterans selected from five test sites will be randomly assigned to one of two groups: (1) patient phone call and tailored, computerized prompt to providers (intervention), or (2) usual care (control). The primary outcome is the proportion of patients receiving pharmacological or other smoking cessation treatment in the six month follow-up period, as assessed from VA pharmacy and outpatient data files. All patients will be recruited to a brief phone interview six months post-intervention to gather secondary outcome measure data related to smoking status, quit history, and use of smoking cessation assistance.

Status:

Data preparation and analysis.

Eligibility criteria: Inclusion Criteria:

Subjects must have received a prescription for a smoking cessation medication in 2002.

Exclusion Criteria:

Primary outcomes:
Secondary outcomes:
Other outcomes:
Locations:
city: Minneapolis
country: United States
facility: Minneapolis VA Health Care System, Minneapolis, MN
state: Minnesota
city: Seattle
country: United States
facility: VA Puget Sound Health Care System Seattle Division, Seattle, WA
state: Washington
Study officials:
affiliation: Minneapolis VA Health Care System, Minneapolis, MN
name: Melissa R. Partin, PhD
role: PRINCIPAL_INVESTIGATOR
affiliation: Minneapolis VA Health Care System, Minneapolis, MN
name: Anne M. Joseph, MD MPH
role: PRINCIPAL_INVESTIGATOR
affiliation: VA Puget Sound Health Care System Seattle Division, Seattle, WA
name: Bonnie G. Steele, PhD RN
role: PRINCIPAL_INVESTIGATOR
References:
citation: Partin MR, An LC, Nelson DB, Nugent S, Snyder A, Fu SS, Willenbring ML, Joseph AM. Randomized trial of an intervention to facilitate recycling for relapsed smokers. Am J Prev Med. 2006 Oct;31(4):293-9. doi: 10.1016/j.amepre.2006.06.021. Epub 2006 Aug 22.
citation: Nelson DB, Partin MR, Fu SS, Joseph AM, An LC. Why assigning ongoing tobacco use is not necessarily a conservative approach to handling missing tobacco cessation outcomes. Nicotine Tob Res. 2009 Jan;11(1):77-83. doi: 10.1093/ntr/ntn013. Epub 2009 Jan 27.
citation: Fu SS, Okuyemi KS, Partin MR, Ahluwalia JS, Nelson DB, Clothier BA, Joseph AM. Menthol cigarettes and smoking cessation during an aided quit attempt. Nicotine Tob Res. 2008 Mar;10(3):457-62. doi: 10.1080/14622200801901914.
citation: Baines AD, Partin MR, Davern M, Rockwood TH. Mixed-mode administration reduced bias and enhanced poststratification adjustments in a health behavior survey. J Clin Epidemiol. 2007 Dec;60(12):1246-55. doi: 10.1016/j.jclinepi.2007.02.011. Epub 2007 Jun 29.
citation: Fu SS, Partin MR, Snyder A, An LC, Nelson DB, Clothier B, Nugent S, Willenbring ML, Joseph AM. Promoting repeat tobacco dependence treatment: are relapsed smokers interested? Am J Manag Care. 2006 Apr;12(4):235-43.