テレグラムメッセンジャーによる心筋梗塞後の禁煙サポート (TELEGRAM-MI)
テレグラムメッセンジャーを介した行動介入が心筋梗塞後の患者の禁煙に及ぼす影響:TELEGRAM-MI無作為化比較試験
This randomized controlled trial will evaluate whether a 6-month behavioral intervention delivered via Telegram messenger increases smoking cessation rates in patients after myocardial infarction (MI).
Adult smokers hospitalized with acute MI who regularly use Telegram will be randomly assigned to either:
- INTERVENTION GROUP: Standard care plus a 6-month Telegram chatbot program providing personalized motivational messages, cognitive-behavioral techniques for craving management, and relapse prevention support.
- CONTROL GROUP: Standard care (routine physician advice to quit smoking) plus basic surveys via Telegram without therapeutic content.
The primary outcome is 30-day point prevalence abstinence at 6 months, verified by blinded telephone interview with participant and corroborating report from a close relative. Secondary outcomes include changes in cigarette consumption, nicotine dependence, motivation, and intervention engagement metrics.
This study addresses the critical gap in smoking cessation support after hospital discharge and could provide evidence for a scalable digital health solution in cardiac secondary prevention.
調査の概要
状態
状態
条件
条件
介入・治療
介入・治療
詳細な説明
The TELEGRAM-MI trial is a multicenter, randomized, controlled, assessor-blinded superiority study testing a digital behavioral intervention for smoking cessation in post-myocardial infarction patients.
BACKGROUND: Smoking cessation is the most effective modifiable risk factor for reducing mortality after MI, yet long-term abstinence remains challenging due to limited sustained support. Digital interventions using popular messaging platforms offer a scalable solution to bridge the post-discharge support gap.
OBJECTIVES:
Primary: To determine if a 6-month Telegram chatbot intervention increases 30-day point prevalence abstinence rates at 6 months compared to standard care alone.
Secondary: To examine associations between baseline characteristics (nicotine dependence, motivation), engagement metrics, and cessation success; and to assess intervention acceptability.
METHODS: Approximately 142 participants will be recruited from inpatient cardiology departments. After providing informed consent, participants will be randomized 1:1 via the chatbot to either the intervention group (standard care plus 6-month behavioral support) or control group (standard care plus data collection only). The intervention incorporates evidence-based techniques including motivational messaging, cognitive-behavioral strategies, and relapse prevention protocols.
OUTCOMES: The primary outcome is biochemically unverified 30-day point prevalence abstinence at 6 months, assessed via blinded telephone interview with participant and relative verification. Secondary outcomes include various smoking behavior metrics collected through the chatbot platform.
ANALYSIS: Primary analysis will follow intention-to-treat principles, with missing data imputed as smoking. Statistical analyses will include chi-square tests for primary outcome and regression models for secondary outcomes.
POTENTIAL IMPACT: If effective, this intervention represents a readily implementable, low-cost strategy to enhance secondary prevention in cardiac patients.
研究の種類
研究の種類
入学 (推定)
入学
段階
段階
- 適用できない
連絡先と場所
研究連絡先
研究連絡先
- 名前:Mikhail A. Kuznetsov, MD
- 電話番号:+79170610352
- メール:mihkuzn@gmail.com
研究連絡先のバックアップ
- 名前:Dmitry V. Sergeev, PhD
- 電話番号:+79802128785
- メール:ser.dmitry.v@gmail.com
研究場所
-
-
-
Ulyanovsk、ロシア
- 募集
- Ulyanovsk Regional Clinical Hospital
-
コンタクト:
- Administration of Clinical Hospital
- 電話番号:+7 8422 32 32 71
- メール:uokb@med.ulgov.ru
-
-
Ulyanovsk Oblast
-
Ulyanovsk、Ulyanovsk Oblast、ロシア、432000
- まだ募集していません
- Ulyanovsk Regional Clinical Hospital
-
コンタクト:
- Mikhail A. Kuznetsov, MD
- 電話番号:+79170610352
- メール:mihkuzn@gmail.com
-
コンタクト:
- Dmitry V. Sergeev, PhD
- 電話番号:+79802128785
- メール:ser.dmitry.v@gmail.com
-
主任研究者:
- Mikhail A. Kuznetsov, MD
-
-
参加基準
適格基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
Inclusion Criteria:
- Willing and able to provide written informed consent.
- Age 18 years or older.
- Hospitalization with a confirmed diagnosis of acute myocardial infarction (MI), including both ST-elevation MI (STEMI) and non-ST-elevation MI (NSTEMI), enrolment occurring either during index hospitalization or within 1 month post-MI at an outpatient visit
- Current smoker at the time of index MI: self-reported smoking of at least one cigarette per day in the month prior to hospitalization.
- Regular user of the Telegram messenger application (app installed on a personal smartphone).
- Possession of a smartphone with internet access and a valid phone number.
- Ability and willingness to provide contact information for a close relative or cohabiting person who can verify smoking status at follow-up.
Exclusion Criteria:
- Smoking cessation more than 1 month prior to the index MI hospitalization.
- Physical or cognitive impairment that prevents the use of a smartphone (e.g., severe visual/hearing impairment, inability to read or respond to messages).
- Inability to read and understand the Russian language fluently.
- Comorbid condition with a life expectancy of less than 1 year.
- Active severe mental illness (e.g., psychosis, severe untreated depression) that would impede understanding of the protocol or adherence.
- Unwillingness or inability to provide contact details for a close relative for outcome verification.
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:処理
- 割り当て:ランダム化
- 介入モデル:並列代入
- マスキング:独身
アーム数
武器と介入
参加者グループ / アーム参加者グループ / アーム |
介入・治療介入・治療 |
|---|---|
|
実験的:Telegram Bot Intervention Group
Participants receive standard care PLUS the 6-month behavioral intervention delivered via the Telegram chatbot. |
A 6-month behavioral intervention delivered via a Telegram chatbot. The intervention includes personalized daily motivational messages, cognitive-behavioral techniques for craving management, access to an SOS/craving support button, weekly check-ins, and relapse prevention protocols. Content is tailored based on user responses to questionnaires (Fagerström Test, Importance/Confidence scales) and engagement metrics. |
|
他の:Standard Care Control Group
Participants receive standard care only. They are connected to the Telegram bot but only complete baseline and follow-up surveys without receiving any active smoking cessation content. |
Routine physician advice to quit smoking provided upon hospital discharge. This represents the current standard of care in the participating clinical centers. |
この研究は何を測定していますか?
主要な結果の測定
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
30-day point prevalence abstinence (PPA)
時間枠:6 months
|
Proportion of participants who report abstinence from smoking for the past 30 days or more, verified by both participant self-report AND corroborating report from a close relative or cohabiting person during a telephone interview conducted by a blinded assessor. A positive outcome is recorded ONLY if both sources confirm abstinence. Participants with missing data (e.g., lost to follow-up) will be considered smokers in the primary analysis (intention-to-treat). |
6 months
|
二次結果の測定
二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
7-day point prevalence abstinence (7-day PPA)
時間枠:1 month and 3 months
|
Proportion of participants who report abstinence from smoking for the past 7 days. Assessed via the Telegram bot. |
1 month and 3 months
|
|
Change in cigarette consumption
時間枠:Baseline, 1 month, 3 months, and 6 months
|
Change from baseline in the self-reported number of cigarettes smoked per day. Assessed via the Telegram bot. |
Baseline, 1 month, 3 months, and 6 months
|
|
Score on the Fagerström Test for Nicotine Dependence (FTND)
時間枠:Baseline and 6 months
|
Change in nicotine dependence measured by the FTND questionnaire (score range 0-10, higher scores indicate greater dependence). Assessed via the Telegram bot. |
Baseline and 6 months
|
|
Motivation to quit (Importance and Confidence Scales)
時間枠:Baseline and 6 months
|
Scores on self-rated scales (0-10) for the importance of quitting and confidence in the ability to quit. Assessed via the Telegram bot. |
Baseline and 6 months
|
|
Participant engagement with the Telegram bot
時間枠:6 months
|
Composite measure of engagement (dose) including: proportion of completed weekly check-ins, proportion of opened messages, number of SOS/craving button uses, number of active weeks. Metrics are automatically logged by the bot. |
6 months
|
|
Intervention acceptability and satisfaction
時間枠:6 months
|
Total score on a custom acceptability and satisfaction questionnaire (5-12 items) completed by participants in the intervention group via the Telegram bot. Higher scores indicate higher satisfaction. |
6 months
|
|
Time to first relapse
時間枠:6 months
|
Number of days from randomization to the first self-reported relapse (lapse) event. Assessed via continuous monitoring through the bot's check-in system. |
6 months
|
協力者と研究者
捜査官
捜査官
- 主任研究者:Mikhail Kuznetsov, MD、Ulyanovsk Regional Clinical Hospital
- スタディディレクター:Dmitry Sergeev, PhD、ITMO University
- スタディディレクター:Artemiy Okhotin, MPH、ITMO University
出版物と役立つリンク
一般刊行物
- Olano-Espinosa E, Avila-Tomas JF, Minue-Lorenzo C, Matilla-Pardo B, Serrano Serrano ME, Martinez-Suberviola FJ, Gil-Conesa M, Del Cura-Gonzalez I; Dejal@ Group. Effectiveness of a Conversational Chatbot (Dejal@bot) for the Adult Population to Quit Smoking: Pragmatic, Multicenter, Controlled, Randomized Clinical Trial in Primary Care. JMIR Mhealth Uhealth. 2022 Jun 27;10(6):e34273. doi: 10.2196/34273.
- Bricker JB, Sullivan BM, Mull KE, Lavista-Ferres J, Santiago-Torres M. Efficacy of a conversational chatbot for cigarette smoking cessation: Protocol of the QuitBot full-scale randomized controlled trial. Contemp Clin Trials. 2024 Dec;147:107727. doi: 10.1016/j.cct.2024.107727. Epub 2024 Oct 28.
- Hayrumyan V, Harutyunyan A, Harutyunyan T. Smoking cessation after myocardial infarction: Findings from a cross-sectional survey in Armenia. Tob Prev Cessat. 2023 Dec 11;9:36. doi: 10.18332/tpc/174359. eCollection 2023.
- Gerber Y, Rosen LJ, Goldbourt U, Benyamini Y, Drory Y; Israel Study Group on First Acute Myocardial Infarction. Smoking status and long-term survival after first acute myocardial infarction a population-based cohort study. J Am Coll Cardiol. 2009 Dec 15;54(25):2382-7. doi: 10.1016/j.jacc.2009.09.020.
- Leosdottir M, Warjerstam S, Michelsen HO, Schlyter M, Hag E, Wallert J, Larsson M. Improving smoking cessation after myocardial infarction by systematically implementing evidence-based treatment methods. Sci Rep. 2022 Jan 12;12(1):642. doi: 10.1038/s41598-021-04634-5.
- Wilson K, Gibson N, Willan A, Cook D. Effect of smoking cessation on mortality after myocardial infarction: meta-analysis of cohort studies. Arch Intern Med. 2000 Apr 10;160(7):939-44. doi: 10.1001/archinte.160.7.939.
研究記録日
主要日程の研究
研究開始 (実際)
研究開始
一次修了 (推定)
一次修了
研究の完了 (推定)
研究の完了
試験登録日
最初に提出
最初に提出
QC基準を満たした最初の提出物
QC基準を満たした最初の提出物
最初の投稿 (実際)
最初の投稿
学習記録の更新
投稿された最後の更新 (実際)
投稿された最後の更新
QC基準を満たした最後の更新が送信されました
QC基準を満たした最後の更新が送信されました
最終確認日
最終確認日
詳しくは
本研究に関する用語
追加の関連 MeSH 用語
その他の研究ID番号
その他の研究ID番号
- TELEGRAM-MI
個々の参加者データ (IPD) の計画
個々の参加者データ (IPD) を共有する予定はありますか?
IPD プランの説明
All individual participant data collected during the trial, after de-identification, will be shared. This includes demographic data, smoking history, questionnaire responses (Fagerström Test, Importance/Confidence scales), intervention engagement metrics, and primary/secondary outcome data.
IPD 共有時間枠
Beginning 12 months after main results publication and ending 5 years after publication. Data will be available for this period.
IPD 共有アクセス基準
Data will be available to researchers who provide a methodologically sound research proposal approved by an independent review committee. Proposals should be directed to the corresponding author. Requestors will need to sign a data access agreement specifying the purpose of analysis, commitment to secure data handling, and agreement not to attempt re-identification of participants.
IPD 共有サポート情報タイプ
- STUDY_PROTOCOL
- SAP
- ICF
- ANALYTIC_CODE
医薬品およびデバイス情報、研究文書
米国FDA規制医薬品の研究
米国FDA規制機器製品の研究
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