Combining Default Choices and a Decision Aid to Improve Tobacco Cessation
- Conditions
- Smoking Cessation
- Interventions
- Behavioral: Refresher courseBehavioral: Training program and decision aid
- Registration Number
- NCT04868474
- Lead Sponsor
- Center for Primary Care and Public Health (Unisante), University of Lausanne, Switzerland
- Brief Summary
The FIRST cluster randomized trial will evaluate the effect of 1) a training program encouraging general practitioners to offer smoking cessation treatment as a default choice to all current smokers consulting a general practitioner (GP), and 2) an interactive, electronic decision aid to guide smoking cessation treatment, on the proportion of current smokers seen in primary care who have quit smoking 6 months after a baseline visit to their GP, as compared to enhanced usual care.
- Detailed Description
Smoking cessation medications are underused in primary care, likely because general practitioners (GP) lack detailed knowledge about prescribing and the fact that smokers seen in primary care must "opt-in" to treatment. Currently GPs only offer treatment to patients who say they are ready to quit smoking and desire treatment, making the default choice no treatment. Those who are not ready to quit or are hesitant do not discuss quitting or learn about options to help them quit. Further, GPs often lack confidence to discuss smoking cessation medications or do not provide patients with a choice. A decision aid can both help to present quitting with a medication as the default choice and promote shared decision making by allowing patients to see the menu of options available.
The current study will combine the use of 'default choices' when approaching smokers and shared decision making with a decision aid for choosing between smoking cessation treatments. The investigators will train GPs to offer smoking cessation as the default choice while involving patients in key decisions using a decision aid. This innovative approach has not been tested in primary care and has the potential to increase the number of current smokers who make a quit attempt with a proven quit aid, thereby increasing the number of patients who quit smoking.
The investigators will implement the training as part of the Vivre sans tabac programme for GPs run by the Swiss Medical Association (FMH).
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 287
Not provided
Not provided
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Usual care training Refresher course A refresher training course will be the equivalent of 'enhanced' usual care. Enhanced because the course will likely augment short-term knowledge of smoking cessation treatments, and participation in the study could trigger more discussions about smoking cessation than routine practice. However, it will be impossible to have any blinding between groups without at least some training. Intervention training Training program and decision aid The training course and decision aid aim to make treatment of tobacco use the default choice
- Primary Outcome Measures
Name Time Method Smoking cessation 6 months follow-up after the baseline visit with a General Practitioner Self-reported, 7-day point-prevalence smoking abstinence
- Secondary Outcome Measures
Name Time Method Quit attempts - patient 6 month follow-up Self-reported quit attempts (periods of abstinence to try to quit smoking) since the baseline visit
Patient participation - patient 3 weeks follow-up Patient-reported participation in discussions about smoking cessation as measured by the CollaboRATE scale
Exhaled Carbon monoxide - patient 6 month follow-up Chemical confirmation of abstinence among those who report 7-day smoking abstinence
Use of quit aids - patient 6 month follow-up Self-reported use of a quit aid (pharmacologic, electronic cigarette, or additional medical visits to discuss quitting) since the baseline visit
Smoking cessation - patient 3 weeks and 3 months follow-up Self-reported, 7-day point-prevalence smoking abstinence
Continuous abstinence - patient 6 month follow-up Self-reported continuous abstinence from the patient's quit date among those who report 7-day smoking abstinence
Trial Locations
- Locations (2)
Maison de santé Mermoz
🇫🇷Lyon, France
Unisante
🇨🇭Lausanne, Vaud, Switzerland