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- Ensaio Clínico NCT02896400
Optimizing Tobacco Dependence Treatment in the Emergency Department
Visão geral do estudo
Status
Condições
Descrição detalhada
The investigators propose to optimize the identification and treatment of adult smokers seen in a hospital ED. To do this the Multiple Optimization Strategy (MOST) will be employed to develop a multicomponent intervention that will consist of some combination of the following: (1) a Brief Negotiation Interview (BNI, a variant of a motivational interview), delivered by a trained research assistant; (2) provision of 6 weeks of nicotine patches and gum to the research participant, with application of the first patch in the ED (NRT); (3) active referral to the Connecticut Smokers' Quitline (QL); and (4) enrollment in the SmokefreeText a short-messaging service (SMS) texting program for mobile phones (Text). Using MOST principles, the first phase of the study will use a 2x2x2x2 full-factorial design to identify the components most likely to be efficacious in combination. Although the factorial design requires the allocation of participants to 16 different combinations of the 4 components (Table 1), evaluation of each individual component is performed comparing all of those receiving a component to all of those not receiving a component, making this an efficient design. For instance, evaluation of the BNI component will compare those randomized to arms 1 through 8 to those in arms 9 to 16.The second phase will consist of designing and proposing a 2-arm randomized clinical trial comparing the efficacy of the multicomponent intervention package to usual care; this will be conducted in a future application.
The specific aims of this proposed study are:
Aim 1. To conduct a fully powered factorial randomized trial of 1056 adult smokers to test the efficacy of 4 key components of ED-initiated tobacco treatment: Brief Negotiated Interview (BNI), nicotine replacement therapy (NRT), Quitline referral (QL), and SmokeFreeText (Text).
Aim 2. To identify the most efficacious components of our intervention, within fixed constraints of cost effectiveness and feasibility/acceptability to providers and subjects.
Aim 3. To lay the groundwork for a future randomized trial testing the previously identified components, delivered as a package, against a control arm in a new cohort of adult ED smokers.
Our associated hypotheses are:
- At 3 months, at least 1 intervention component will yield a biochemically verified tobacco abstinence rate at least 5% greater than in the control condition. Carbon monoxide breath test will be used for biochemical verification.
- At 3 months, at least 1 intervention will be cost-effective, using a societal perspective.
- At 3 months, at least 1 intervention will be acceptable and feasible to providers and subjects.
Tipo de estudo
Inscrição (Real)
Estágio
- Fase 3
Contactos e Locais
Locais de estudo
-
-
Connecticut
-
New Haven, Connecticut, Estados Unidos, 06519
- Yale School of Medicine
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-
Critérios de participação
Critérios de elegibilidade
Idades elegíveis para estudo
Aceita Voluntários Saudáveis
Gêneros Elegíveis para o Estudo
Descrição
Inclusion Criteria:
- 18 years or older
- have smoked >= 100 cigarettes lifetime
- describe themselves as every or some day smokers
- smoke at least 5 cigarettes/day
- own a cellphone with texting capability
- are able to give written informed consent
Exclusion Criteria:
- Inability to read or understand English
- currently receiving formal tobacco dependence treatment
- life-threatening or unstable medical, surgical, or psychobehavioral condition
- unable to provide at least one collateral contact
- live out-of-state
- leaving the ED against medical advice
- pregnant (self-report or urine testing), nursing, or trying to conceive.
Plano de estudo
Como o estudo é projetado?
Detalhes do projeto
- Finalidade Principal: Tratamento
- Alocação: Randomizado
- Modelo Intervencional: Atribuição fatorial
- Mascaramento: Solteiro
Armas e Intervenções
Grupo de Participantes / Braço |
Intervenção / Tratamento |
---|---|
Experimental: BNI+NRT+QL+Text
Brief Negotiated Interview (BNI) Nicotine replacement therapy (NRT) patches and gum, 6 weeks supply Referral to CT Smokers Quitline (QL) Registration in SmokefreeText (Text)
|
Brief motivational interview on smoking behavior
6 weeks of nicotine replacement, patches and gum.
First dose of each started in ED.
Patches are 14mg or 21 mg.
Gum is 2mg per piece.
Faxed referral to the CT Smokers Quitline for the subject.
QL will then call subject to offer phone based counseling.
Enrollment in a version of NCI's SmokefreeTxt, tailored for the study.
|
Experimental: BNI+NRT+QL
Brief Negotiated Interview (BNI) Nicotine replacement therapy (NRT) patches and gum, 6 weeks supply Referral to CT Smokers Quitline (QL)
|
Brief motivational interview on smoking behavior
6 weeks of nicotine replacement, patches and gum.
First dose of each started in ED.
Patches are 14mg or 21 mg.
Gum is 2mg per piece.
Faxed referral to the CT Smokers Quitline for the subject.
QL will then call subject to offer phone based counseling.
|
Experimental: BNI+NRT+Text
Brief Negotiated Interview (BNI) Nicotine replacement therapy (NRT) patches and gum, 6 weeks supply Registration in SmokefreeText (Text)
|
Brief motivational interview on smoking behavior
6 weeks of nicotine replacement, patches and gum.
First dose of each started in ED.
Patches are 14mg or 21 mg.
Gum is 2mg per piece.
Enrollment in a version of NCI's SmokefreeTxt, tailored for the study.
|
Experimental: BNI+NRT
Brief Negotiated Interview (BNI) Nicotine replacement therapy (NRT) patches and gum, 6 weeks supply
|
Brief motivational interview on smoking behavior
6 weeks of nicotine replacement, patches and gum.
First dose of each started in ED.
Patches are 14mg or 21 mg.
Gum is 2mg per piece.
|
Experimental: BNI+QL+Text
Brief Negotiated Interview (BNI) Referral to CT Smokers Quitline (QL) Registration in SmokefreeText (Text)
|
Brief motivational interview on smoking behavior
Faxed referral to the CT Smokers Quitline for the subject.
QL will then call subject to offer phone based counseling.
Enrollment in a version of NCI's SmokefreeTxt, tailored for the study.
|
Experimental: BNI+QL
Brief Negotiated Interview (BNI) Referral to CT Smokers Quitline (QL)
|
Brief motivational interview on smoking behavior
Faxed referral to the CT Smokers Quitline for the subject.
QL will then call subject to offer phone based counseling.
|
Experimental: BNI+Text
Brief Negotiated Interview (BNI) Registration in SmokefreeText (Text)
|
Brief motivational interview on smoking behavior
Enrollment in a version of NCI's SmokefreeTxt, tailored for the study.
|
Experimental: BNI only
Brief Negotiated Interview (BNI)
|
Brief motivational interview on smoking behavior
|
Experimental: NRT+QL+Text
Nicotine replacement therapy (NRT) patches and gum, 6 weeks supply Referral to CT Smokers Quitline (QL) Registration in SmokefreeText (Text)
|
6 weeks of nicotine replacement, patches and gum.
First dose of each started in ED.
Patches are 14mg or 21 mg.
Gum is 2mg per piece.
Faxed referral to the CT Smokers Quitline for the subject.
QL will then call subject to offer phone based counseling.
Enrollment in a version of NCI's SmokefreeTxt, tailored for the study.
|
Experimental: NRT+QL
Nicotine replacement therapy (NRT) patches and gum, 6 weeks supply Referral to CT Smokers Quitline (QL)
|
6 weeks of nicotine replacement, patches and gum.
First dose of each started in ED.
Patches are 14mg or 21 mg.
Gum is 2mg per piece.
Faxed referral to the CT Smokers Quitline for the subject.
QL will then call subject to offer phone based counseling.
|
Experimental: NRT+Text
Nicotine replacement therapy (NRT) patches and gum, 6 weeks supply Registration in SmokefreeText (Text)
|
6 weeks of nicotine replacement, patches and gum.
First dose of each started in ED.
Patches are 14mg or 21 mg.
Gum is 2mg per piece.
Enrollment in a version of NCI's SmokefreeTxt, tailored for the study.
|
Experimental: NRT only
Nicotine replacement therapy (NRT) patches and gum, 6 weeks supply
|
6 weeks of nicotine replacement, patches and gum.
First dose of each started in ED.
Patches are 14mg or 21 mg.
Gum is 2mg per piece.
|
Experimental: QL+Text
Referral to CT Smokers Quitline (QL) Registration in SmokefreeText (Text)
|
Faxed referral to the CT Smokers Quitline for the subject.
QL will then call subject to offer phone based counseling.
Enrollment in a version of NCI's SmokefreeTxt, tailored for the study.
|
Experimental: QL only
Referral to CT Smokers Quitline (QL)
|
Faxed referral to the CT Smokers Quitline for the subject.
QL will then call subject to offer phone based counseling.
|
Experimental: Text only
Registration in SmokefreeText (Text)
|
Enrollment in a version of NCI's SmokefreeTxt, tailored for the study.
|
Sem intervenção: Control
Control arm, no intervention
|
O que o estudo está medindo?
Medidas de resultados primários
Medida de resultado |
Descrição da medida |
Prazo |
---|---|---|
Tobacco Abstinence
Prazo: 3 months
|
Abstinence self reported and verified by exhaled carbon monoxide
|
3 months
|
Colaboradores e Investigadores
Patrocinador
Investigadores
- Investigador principal: Steven L Bernstein, MD, Yale School of Medicine, Department of Emergency Medicine
Publicações e links úteis
Datas de registro do estudo
Datas Principais do Estudo
Início do estudo (Real)
Conclusão Primária (Real)
Conclusão do estudo (Real)
Datas de inscrição no estudo
Enviado pela primeira vez
Enviado pela primeira vez que atendeu aos critérios de CQ
Primeira postagem (Estimativa)
Atualizações de registro de estudo
Última Atualização Postada (Real)
Última atualização enviada que atendeu aos critérios de controle de qualidade
Última verificação
Mais Informações
Termos relacionados a este estudo
Termos MeSH relevantes adicionais
- Transtornos Mentais, Desordem Mental
- Distúrbios induzidos quimicamente
- Processos Patológicos
- Transtornos Relacionados a Substâncias
- Atributos da doença
- Emergências
- Transtorno do Uso de Tabaco
- Efeitos Fisiológicos das Drogas
- Agentes Neurotransmissores
- Mecanismos Moleculares de Ação Farmacológica
- Agentes Autônomos
- Agentes do Sistema Nervoso Periférico
- Agentes colinérgicos
- Estimulantes ganglionares
- Agonistas Nicotínicos
- Agonistas colinérgicos
- Nicotina
Outros números de identificação do estudo
- 1603017332
- 1R01CA201873-01A1 (Concessão/Contrato do NIH dos EUA)
Plano para dados de participantes individuais (IPD)
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