Integrating Smoking Cessation Into Routine Primary Care Practice
Comparative Evaluation of the Efficacy and Cost-effectiveness of Two Interventions for Integrating Smoking Cessation Into Routine Primary Care Practice: A Cluster-randomized Trial
調査の概要
状態
条件
詳細な説明
A family doctor's advice to quit has been shown to increase a smoker's motivation to quit. Despite the evidence supporting the importance of smoking cessation, there is a well-documented practice gap in the rates at which smoking cessation is being addressed by practitioners. The primary objectives of this research study are to determine whether adjunct telephone-based smoking cessation follow-up counselling when delivered as part of a multi-component intervention:
- Increases the rate at which evidence-based smoking cessation interventions are delivered to smokers identified in family doctors offices, compared to providing only practice supports.
- Increases smoking abstinence as measured three months after the estimated target quit date (i.e.16 weeks) compared to providing only practice supports.
- Is more cost-effective (cost/quit) than providing only practice supports to family doctors offices.
A two-arm before-after matched-pair cluster randomized trial, will test the effectiveness of two strategies for integrating smoking cessation treatments into primary care practice routines and enhancing cessation. Six to eight family doctors offices will be randomized to either a practice support (PS) group, or a follow-up counseling (FC) group. From each of the intervention practices a cross-sectional sample of 50 eligible smokers will be recruited pre- and post-intervention to assess 5A's delivery and smoking abstinence.
研究の種類
入学 (実際)
段階
- 適用できない
参加基準
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:
Practices will be eligible for participation in the present study if they meet the following criteria:
- Practice is a family health team (FHT), family health group (FHG); or family health network (FHN);
- All physicians within the practice are willing to participate in the study;
- Practice will see an average of 50 patients per day and 10% of patients are smokers;
- Practice is willing to provide consent to contact patients in waiting rooms and survey patients during office hours and by telephone.
Patients will be eligible to participate in the study if they meet the following criteria:
- Patient is seen in clinic for annual exam or non-urgent visit;
- Patient is a current smoker (>1 cigarette per day on most days of the week);
- Patient is 18 years of age or older;
- Patient is able to read and understand English or French;
- Patient has a home or mobile telephone which can be used to receive follow-up telephone counselling calls
Exclusion Criteria:
- Patients who do not have the mental capacity to provide informed consent and complete study protocols will be excluded.
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：防止
- 割り当て：ランダム化
- 介入モデル：並列代入
- マスキング：なし（オープンラベル）
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
|
実験的：Follow-up Counseling Arm
smoking cessation training for providers,practice tools for providers, patient quit plan, and follow-up telephone counselling for smokers
|
The CF group will receive the same smoking cessation training and practice support tools delivered to the PS group.
In addition, patients in the FC group who are smokers and are willing to set a quit date within the next 30 days and who have set a quit date will be enrolled in an interactive voice response (IVR)-mediated telephone follow-up and counselling system.
The IVR system will automatically contact patients via telephone 7 days before their TQD, and 5, 14, 30, and 60 days after their TQD to check the patients' smoking status, potential concerns, and their risk of relapse.
|
|
アクティブコンパレータ：Practice Support Arm
smoking cessation training for providers,practice tools for providers, patient quit plan for smokers.
|
Intervention practices will be provided with training in smoking cessation, and will be supported with integrating a waiting room screener for smoking and smoking consult form and patient quit plan into their practice routines.
|
この研究は何を測定していますか？
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
smoking abstinence
時間枠：16-weeks
|
Self-report and biochemically validated point prevelence smoking abstinence
|
16-weeks
|
二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
cost-effectiveness
時間枠：16-weeks
|
16-weeks
|
|
|
Rate of provider delivery of evidence-based smoking treatments
時間枠：exit survey on day of clinic visits
|
Rates of providers, asking, advising, assessing, assisting, and arranging were assessed
|
exit survey on day of clinic visits
|
協力者と研究者
スポンサー
捜査官
- 主任研究者：Paul McDonald, PhD、University of Waterloo
研究記録日
主要日程の研究
研究開始
一次修了 (実際)
研究の完了 (実際)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (見積もり)
学習記録の更新
投稿された最後の更新 (見積もり)
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
詳しくは
本研究に関する用語
その他の研究ID番号
- 15053
- CTCRI 019826 (その他の助成金/資金番号：Canadian Tobacco Control Research Initiative)
- CTCRI 19813 (その他の助成金/資金番号：Canadian Tobacco Control Research Initiative)
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
米国で製造され、米国から輸出された製品。
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