Tobacco dependence treatment in the emergency department: A randomized trial using the Multiphase Optimization Strategy
© 2018 The Authors Background: Tobacco dependence remains the leading preventable cause of death in the developed world. Smokers are disproportionately from lower socioeconomic groups, and may use the hospital emergency department (ED) as an important source of care. A recent clinical trial demonstr...
| Main Authors: | , , , , , , , , , |
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| Format: | Journal Article |
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Elsevier Inc.
2018
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| Online Access: | http://hdl.handle.net/20.500.11937/68483 |
| _version_ | 1848761813650374656 |
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| author | Bernstein, S. Dziura, J. Weiss, J. Miller, Ted Vickerman, K. Grau, L. Pantalon, M. Abroms, L. Collins, L. Toll, B. |
| author_facet | Bernstein, S. Dziura, J. Weiss, J. Miller, Ted Vickerman, K. Grau, L. Pantalon, M. Abroms, L. Collins, L. Toll, B. |
| author_sort | Bernstein, S. |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | © 2018 The Authors Background: Tobacco dependence remains the leading preventable cause of death in the developed world. Smokers are disproportionately from lower socioeconomic groups, and may use the hospital emergency department (ED) as an important source of care. A recent clinical trial demonstrated the efficacy of a multicomponent intervention to help smokers quit, but the independent contributions of those components is unknown. Methods: This is a full-factorial (16-arm) randomized trial in a busy hospital ED of 4 tobacco dependence interventions: brief motivational interviewing, nicotine replacement therapy, referral to a telephone quitline, and a texting program. The trial utilizes the Multiphase Optimization Strategy (MOST) and a novel mixed methods analytic design to assess clinical efficacy, cost effectiveness, and qualitative participant feedback. The primary endpoint is tobacco abstinence at 3 months, verified by participants' exhaled carbon monoxide. Results: Study enrollment began in February 2017. As of April 2017, 52 of 1056 planned participants (4.9%) were enrolled. Telephone-based semi-structured participant interviews and in-person biochemical verification of smoking abstinence are completed at the 3-month follow-up. Efficacy and cost effectiveness analyses will be conducted after follow-up is completed. Discussion: The goal of this study is to identify a clinically efficacious, cost-effective intervention package for the initial treatment of tobacco dependence in ED patients. The efficacy of this combination can then be tested in a subsequent confirmatory trial. Our approach incorporates qualitative feedback from study participants in evaluating which intervention components will be tested in the future trial. Trial registration: Trial (NCT02896400) registered in ClinicalTrials.gov on September 6, 2016. |
| first_indexed | 2025-11-14T10:37:38Z |
| format | Journal Article |
| id | curtin-20.500.11937-68483 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| last_indexed | 2025-11-14T10:37:38Z |
| publishDate | 2018 |
| publisher | Elsevier Inc. |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-684832018-06-29T12:34:53Z Tobacco dependence treatment in the emergency department: A randomized trial using the Multiphase Optimization Strategy Bernstein, S. Dziura, J. Weiss, J. Miller, Ted Vickerman, K. Grau, L. Pantalon, M. Abroms, L. Collins, L. Toll, B. © 2018 The Authors Background: Tobacco dependence remains the leading preventable cause of death in the developed world. Smokers are disproportionately from lower socioeconomic groups, and may use the hospital emergency department (ED) as an important source of care. A recent clinical trial demonstrated the efficacy of a multicomponent intervention to help smokers quit, but the independent contributions of those components is unknown. Methods: This is a full-factorial (16-arm) randomized trial in a busy hospital ED of 4 tobacco dependence interventions: brief motivational interviewing, nicotine replacement therapy, referral to a telephone quitline, and a texting program. The trial utilizes the Multiphase Optimization Strategy (MOST) and a novel mixed methods analytic design to assess clinical efficacy, cost effectiveness, and qualitative participant feedback. The primary endpoint is tobacco abstinence at 3 months, verified by participants' exhaled carbon monoxide. Results: Study enrollment began in February 2017. As of April 2017, 52 of 1056 planned participants (4.9%) were enrolled. Telephone-based semi-structured participant interviews and in-person biochemical verification of smoking abstinence are completed at the 3-month follow-up. Efficacy and cost effectiveness analyses will be conducted after follow-up is completed. Discussion: The goal of this study is to identify a clinically efficacious, cost-effective intervention package for the initial treatment of tobacco dependence in ED patients. The efficacy of this combination can then be tested in a subsequent confirmatory trial. Our approach incorporates qualitative feedback from study participants in evaluating which intervention components will be tested in the future trial. Trial registration: Trial (NCT02896400) registered in ClinicalTrials.gov on September 6, 2016. 2018 Journal Article http://hdl.handle.net/20.500.11937/68483 10.1016/j.cct.2017.12.016 Elsevier Inc. restricted |
| spellingShingle | Bernstein, S. Dziura, J. Weiss, J. Miller, Ted Vickerman, K. Grau, L. Pantalon, M. Abroms, L. Collins, L. Toll, B. Tobacco dependence treatment in the emergency department: A randomized trial using the Multiphase Optimization Strategy |
| title | Tobacco dependence treatment in the emergency department: A randomized trial using the Multiphase Optimization Strategy |
| title_full | Tobacco dependence treatment in the emergency department: A randomized trial using the Multiphase Optimization Strategy |
| title_fullStr | Tobacco dependence treatment in the emergency department: A randomized trial using the Multiphase Optimization Strategy |
| title_full_unstemmed | Tobacco dependence treatment in the emergency department: A randomized trial using the Multiphase Optimization Strategy |
| title_short | Tobacco dependence treatment in the emergency department: A randomized trial using the Multiphase Optimization Strategy |
| title_sort | tobacco dependence treatment in the emergency department: a randomized trial using the multiphase optimization strategy |
| url | http://hdl.handle.net/20.500.11937/68483 |