- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT06161675
Feasibility of Delivering VergeRx at FQHCs
December 9, 2023 updated by: Melissa Little, PhD, MPH, University of Virginia
Determining the Feasibility of Delivering VergeRx to Smokers Through Pharmacies in Federally Qualified Health Centers Regardless of Readiness to Quit
Cigarette smoking in the U.S. is highest among low income and Medicaid insured adults, and unfortunately, low-income smokers are even less likely to attempt to quit, less likely to use evidence-based treatments, and thus less likely to be successful.
Federally Qualified Health Centers (FQHCs), which generally provide healthcare services to low income and Medicaid insured patients, are more likely to serve individuals who use tobacco and are required to report tobacco use screening rates and their delivery of cessation interventions.
Thus, FQHCs are an ideal community-partner to reach low-income smokers, particularly smokers who are not currently seeking treatment.
To address this gap, the investigators developed a pharmacist-delivered smoking cessation intervention to help facilitate nicotine replacement therapy medication adherence among smokers.
The proposed study aims to examine the feasibility of delivering the pharmacist-delivered smoking cessation intervention to FQHC patients who are ready to quit, and expanding the intervention for smokers not ready to quit by adding 2 pre-quit sessions focused on rate reduction.
The investigators will also determine facilitators and barriers to adopting and implementing the program in FQHCs.
Study Overview
Status
Not yet recruiting
Conditions
Intervention / Treatment
Detailed Description
Cigarette smoking in the U.S. is highest among low income and Medicaid insured adults, and unfortunately, low-income smokers are even less likely to attempt to quit, less likely to use evidence-based treatments, and thus less likely to be successful.
Federally Qualified Health Centers (FQHCs), which generally provide healthcare to low income and Medicaid insured patients, are more likely to serve individuals who use tobacco, and are required to report tobacco use screening rates and deliver cessation interventions.
Thus, FQHCs are an ideal community-partner to reach low-income smokers.
The investigators developed a pharmacist-delivered medication management program for smoking cessation to help facilitate nicotine replacement therapy medication adherence, and the investigators piloted the program in a rural Appalachian community pharmacy and found that the intervention was acceptable and feasible to pharmacists and smokers.
The investigators are currently testing the effectiveness of the intervention along with standard, evidence-based tobacco treatments among rural smokers in Appalachia with a pharmacist-delivered approach in a R01 funded by NCI (R01CA267963, PI Little).
However, given the low-income population served by FQHCs, there are likely unique barriers to smoking cessation in this setting.
The investigators examined tobacco cessation services at pharmacies within FQHCs as well as potential barriers and facilitators to implementing a QuitAid program in this setting.
The investigators found that only 43.5% provided smoking cessation to patients, and these services were limited to help seeking only smokers who were ready to quit.
Thus, an opportunity exists to utilize pharmacists at FQHCs to maximize the reach of smoking cessation interventions, to both smokers ready to quit and those who are not yet ready to quit.
The proposed study builds logically on this preliminary work by examining the feasibility of delivering a pharmacist-delivered medication management program for smoking cessation to FQHC patients who are ready to quit, and expanding this research for smokers who are not ready to quit by adding 2 pre-quit sessions focused on Rate Reduction (RR).
Thus, the aims of the current study are: (1) Determine the feasibility of implementing a pharmacist-delivered medication management program for smoking cessation for smokers ready to quit and for smokers not ready to quit in FQHC pharmacies; and (2) Use an implementation science approach to determine facilitators and barriers to adopting and implementing a pharmacist delivered smoking cessation program in FQHCs.
The proposed work will provide foundational evidence for a larger trial to determine the efficacy of these interventions.
Study Type
Interventional
Enrollment (Estimated)
100
Phase
- Not Applicable
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Contact
- Name: Dylan Allanson, MPH, RD
- Phone Number: 4342430424
- Email: da4ac@virginia.edu
Study Contact Backup
- Name: Leslie A Gladney, MA
- Email: lag3z@virginia.edu
Study Locations
-
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Virginia
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Charlottesville, Virginia, United States, 22903
- University of Virginia
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Principal Investigator:
- Melissa A Little, PhD,MPH
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Contact:
- Dylan D Allanson, MPH, RD
- Email: da4ac@virginia.edu
-
Sub-Investigator:
- Rebecca A Krukowski, PhD, MA
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Sub-Investigator:
- Kara P Wiseman, PhD, MA
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Sub-Investigator:
- Roger T Anderson, PhD
-
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Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Yes
Description
Inclusion Criteria:
- patient at participating Federally Qualified Health Center
- ≥18 years of age
- able to read, speak, and understand English
- report smoking ≥5 cigarettes per day for the past 6 months
- own a cell phone
- be willing and able to use NRT in the form of patch or lozenge
- not be pregnant or planning to be pregnant in the next 6 months
Exclusion Criteria:
- have a medical contraindication to NRT (e.g., past 30 days, heart attack or stroke; past 6 months, serious or worsening angina, very rapid or irregular heartbeat requiring medication)
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Factorial Assignment
- Masking: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: QuitAid + SmokefreeTXT + NRT (Patch + Lozenge)
Participants will receive QuitAid, a medication therapy management delivered by their pharmacist, a texting intervention to help quit smoking, and up to 8 weeks Nicotine Replacement Therapy (NRT) in the form of the nicotine patch + lozenge.
|
Participants will receive the QuitAid intervention, based on a medication adherence intervention, which addresses perceptions (e.g., motivation, self-efficacy, beliefs) and practicalities of using NRT (e.g., monitoring NRT use, establishing a reminder system).
QuitAid includes 1 in-person session and 5 follow-up telephonic sessions with the participant's local pharmacist/technician.
Smokers not ready to quit will receive up to two sessions focused on using NRT to cut down cigarette use.
If a smoker decides they are ready to quit at the 2- or 4-week follow-ups, they will receive the full QuitAid intervention.
Other Names:
All participants will receive the SmokefreeTXT is a text-messaging program offered through the National Cancer Institute's Smokefree.gov
initiative, which sends pre-programmed messages timed around a quit date.
Participants will receive 3-5 messages a day for 7 weeks.
The first week of messages focus on preparation and the remaining 6 weeks of messages focus on post-cessation strategies (e.g., relapse prevention), all timed relative to the quit date set at enrollment.
For smokers not ready to quit, participants will receive two week-long pre-quit modules, Practice Quit and Daily Challenges.
These modules will help the smoker become comfortable with not smoking for short periods of time and build skills before they attempt to quit.
If a smoker decides they are ready to quit at the 2- or 4-week follow-ups, they will receive the ready to quit treatment.
All participants will receive up to 8 weeks of NRT in the form of patch.
At the 4-week follow-up, all participants still smoking will be offered an additional 4 weeks of NRT, regardless of readiness to quit.
NRT temporarily replaces nicotine from tobacco to reduce motivation to consume tobacco and nicotine withdrawal symptoms.
Other Names:
All participants will receive up to 8 weeks of NRT in the form of lozenge.
At the 4-week follow-up, all participants still smoking will be offered an additional 4 weeks of NRT, regardless of readiness to quit.
NRT temporarily replaces nicotine from tobacco to reduce motivation to consume tobacco and nicotine withdrawal symptoms.
Other Names:
|
Active Comparator: SmokefreeTXT + NRT (Patch + Lozenge)
Participants will receive a texting intervention to help quit smoking and up to 8 weeks Nicotine Replacement Therapy (NRT) in the form of the nicotine patch + lozenge.
|
All participants will receive the SmokefreeTXT is a text-messaging program offered through the National Cancer Institute's Smokefree.gov
initiative, which sends pre-programmed messages timed around a quit date.
Participants will receive 3-5 messages a day for 7 weeks.
The first week of messages focus on preparation and the remaining 6 weeks of messages focus on post-cessation strategies (e.g., relapse prevention), all timed relative to the quit date set at enrollment.
For smokers not ready to quit, participants will receive two week-long pre-quit modules, Practice Quit and Daily Challenges.
These modules will help the smoker become comfortable with not smoking for short periods of time and build skills before they attempt to quit.
If a smoker decides they are ready to quit at the 2- or 4-week follow-ups, they will receive the ready to quit treatment.
All participants will receive up to 8 weeks of NRT in the form of patch.
At the 4-week follow-up, all participants still smoking will be offered an additional 4 weeks of NRT, regardless of readiness to quit.
NRT temporarily replaces nicotine from tobacco to reduce motivation to consume tobacco and nicotine withdrawal symptoms.
Other Names:
All participants will receive up to 8 weeks of NRT in the form of lozenge.
At the 4-week follow-up, all participants still smoking will be offered an additional 4 weeks of NRT, regardless of readiness to quit.
NRT temporarily replaces nicotine from tobacco to reduce motivation to consume tobacco and nicotine withdrawal symptoms.
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Feasibility of Recruitment
Time Frame: 6 months
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Measured by (a) the proportion of smokers recruited from each source (e.g., ask-advise-prescribe, posters, prescription bag advertisements) and (b) the number of smokers recruited per month.
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6 months
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Feasibility of Randomization
Time Frame: 6 months
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Determine the number of smokers that will needed to be approached and screened in order to randomize 100 smokers (e.g., ineligible smokers, smokers that do not consent) in six months across two FQHCs.
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6 months
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Feasibility of Retention
Time Frame: 12 weeks
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Assessment of the proportion of smokers who complete the 12-week follow-up.
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12 weeks
|
Dose of the MTM intervention
Time Frame: 12 weeks
|
Dose of the MTM intervention will be defined at the number of MTM sessions the participant received as documented in the REDCap database by the pharmacists.
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12 weeks
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Dose of the NRT
Time Frame: 12 weeks
|
Dose of NRT will be defined as the percent of NRT used and will be collected from participants at the follow-ups.
|
12 weeks
|
Dose of SmokefreeTXT
Time Frame: 12 weeks
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Dose of SmokefreeTXT will be defined by the use of keywords, responses to the within-program assessment questions, and date of SmokefreeTXT opt out (i.e., texted "STOP", if applicable).
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12 weeks
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Biochemical Verification of Tobacco Abstinence by Participants
Time Frame: 12 weeks
|
The investigators will assess self-reported point prevalence abstinence defined as not smoking (even a puff) within the past seven days.
If a participant reports no tobacco use in the previous 7-days at the at the 12-week follow-up point, we will ask them to go into their FQHC pharmacy where their pharmacist will biochemically verify their abstinence using Microport Smokelyzer carbon monoxide monitors within 48 hours.
We will consider cutoff in the range of 3-4 ppm for carbon monoxide as viable cutoff to determine abstinence in their saliva to be smokers; this liberal definition will avoid false positives due to secondhand smoke.
Lower results will indicate if smoking cessation treatment has been effective.
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12 weeks
|
Quit Attempts
Time Frame: 12 weeks
|
The number of times that participants have made a quit attempt since the previous contact at the 2-, 4-, 8- and 12-week follow-ups via electronic survey.
A "quit attempt" will be defined as cigarette abstinence for ≥ 24 hours not due to involuntary or forced cessation (i.e., hospitalization).
Lower results will indicate if smoking cessation treatment has been effective.
|
12 weeks
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Investigators
- Principal Investigator: Melissa A Little, PhD,MPH, University of Virginia
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Estimated)
March 1, 2024
Primary Completion (Estimated)
March 1, 2025
Study Completion (Estimated)
March 1, 2026
Study Registration Dates
First Submitted
September 8, 2023
First Submitted That Met QC Criteria
November 29, 2023
First Posted (Actual)
December 8, 2023
Study Record Updates
Last Update Posted (Estimated)
December 15, 2023
Last Update Submitted That Met QC Criteria
December 9, 2023
Last Verified
December 1, 2023
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- HSR 230207
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
NO
IPD Plan Description
Data Management System.
This study will use REDCap electronic data capture tools hosted at the University of Virginia.
The database will be hosted on secure, HIPAA-compliant UVA computing servers and its access will be restricted to authorized individuals.
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
product manufactured in and exported from the U.S.
No
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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