- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03276806
Inpatient Smokers and LDCT Screening RCT
Capitalizing on Hospitalization to Engage Low SES Smokers in LDCT Screening: A Randomized Controlled Trial
Study Overview
Status
Conditions
Detailed Description
The goal of this study is to create and evaluate an intervention that capitalizes on hospitalization at an urban safety net hospital as an opportunity to connect high risk smokers to lung cancer screening and smoking cessation services. Building on the well-established inpatient tobacco dependence consult service at Boston Medical Center, the investigators will study the effect of adding a nurse-driven LDCT screening SDM intervention to inpatient smoking cessation counseling among screen-eligible hospitalized smokers. Hospitalization may be an ideal time-point for this intervention as it offers 1) a "teachable moment" for patients, when they may be particularly receptive to interventions to reduce smoking-related disease, and 2) an opportunity to offload busy PCPs of the obligation to conduct SDM for LDCT screening.
In Aim 1, screen-eligible patients who are smokers will be randomized into one of the study arms (n=284, 142 per arm) to receive either inpatient 1) SDM (SDM by a thoracic oncology nurse using a decision aid) or 2) usual care and a LDCT informational brochure during inpatient smoking cessation consultation visits. In both arms the thoracic oncology nurse will counsel patients on smoking cessation. The investigators hypothesize that for screen-eligible smokers, inpatient SDM will increase (1) LDCT screening rates, (2) patient knowledge of LDCT screening, and (3) 1 month smoking quit rates compared to usual care.
In Aim 2, the potential for future implementation of the intervention will be evaluated by incorporating stakeholder impressions of the intervention through qualitative interviews. By study end, an inpatient intervention will be created to promote both LDCT screening and smoking cessation among low income and minority smokers. This hybrid study will allow te investigators to establish not only the effectiveness of the intervention, but also help inform future implementation.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
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Massachusetts
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Boston, Massachusetts, United States, 02118
- Boston Medical Center
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-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- hospitalized smokers at BMC meeting LDCT screening eligible criteria
- males and females 55-80 years of age
- ≥30-pack years smoking
- current smoker
- able to speak, read, and understand English
- able and willing to participate and provide informed consent
Exclusion Criteria:
- severe co-morbidities expected to limit life expectancy or ability to tolerate surgical resection of a lung cancer, including patients requiring home oxygen therapy (an indicator of severe lung or heart disease), and patients with active cancer
- patients who have already had LDCT screening in the past year
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Diagnostic
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: SDM + decision aid + tobacco counseling
Participants will receive tobacco dependence/smoking cessation counseling by a nurse, SDM and a decision aid.
|
Standard of care tobacco dependence/smoking cessation counseling offered to all smokers at Boston Medical Center.
SDM is three-fold to: 1) conduct a tailored discussion on tradeoffs of LDCT screening, consistent with CMS requirements for SDM using a decision aid; 2) directly connect interested patients to LDCT screening; 3) to empower and motivate patients to quit smoking within the LDCT screening context.
Other Names:
The decision aid is a 4-page paper format with the following features: 1) LDCT screening harms and benefits information, written in plain language and using pictographs, easily understood by those with low health literacy; 2) prompts to clarify patient values and preferences and to stimulate discussion about trade-offs; 3) clear quit smoking messaging and resources (1-800-QUIT-NOW).
|
Active Comparator: LDCT brochure + tobacco counseling
Participants will receive tobacco dependence/smoking cessation counseling by a nurse and a LDCT informational brochure.
|
Standard of care tobacco dependence/smoking cessation counseling offered to all smokers at Boston Medical Center.
A informational brochure developed by the BMC screening program about low dose CT screening for lung cancer.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Completion of LDCT screening
Time Frame: 3 months
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The electronic records review and from the Lung Cancer Screening clinical database created by the Department of Pulmonary Disease and Critical Care at BMC will be reviewed to determine which participants have completed LDCT screening designated as yes or no and if yes the date of the LDCT screening will be recorded..
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3 months
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Knowledge of LDCT screening (experimental group)
Time Frame: Baseline, immediately post SDM, 1 month
|
A 21 item instrument developed by Lau and colleagues and modified for a low health literacy population by Crothers will be used.
The instrument includes true/false and multiple choice questions that will be used to determine a total score representing knowledge of LDCT screening.
The mean percentage of correct responses will be measured so higher scores are better suggesting more knowledge about LDCT screening.
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Baseline, immediately post SDM, 1 month
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Knowledge of LDCT screening (active comparator group)
Time Frame: Baseline, 1 month
|
A 21 item instrument developed by Lau and colleagues and modified for a low health literacy population by Crothers will be used.
The instrument includes true/false and multiple choice questions that will be used to determine a total score representing knowledge of LDCT screening.
|
Baseline, 1 month
|
smoking cessation
Time Frame: 4 weeks
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Dichotomous outcome by self-report of prolonged abstinence at 4 weeks and 7-day point prevalence at 4 weeks, as recommended by the Society for Research on Nicotine and Tobacco and the Russell Standard.
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4 weeks
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Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Hasmeena Kathuria, MD, Assistant professor
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- H-36854
- LCD-507875 (Other Grant/Funding Number: American Lung Association (ALA))
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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