Electronic Proactive Outreach for Smokers With COPD

Not Applicable

Completed

Conditions: Smoking
Pulmonary Disease, Chronic Obstructive

Registration Number: NCT04462289

Lead Sponsor: VA Office of Research and Development

Brief Summary: Chronic obstructive pulmonary disease (COPD) is one of the most common respiratory diseases, with 90% of cases directly attributable to smoking. Unfortunately, many patients continue to smoke and have an urgent need to quit. Proactive tobacco treatment programs identify patients outside of a routine clinical appointment and engage them in making a supported quit attempt.

Most previous research of proactive tobacco treatment has used telephone outreach, which can be resource intensive. Electronic methods (texting, secure messaging) may be effective while requiring fewer resources.

In this study, the investigators will adapt a clinically available motivational texting program with content tailored to smokers with COPD. First, information will be gathered from smokers with COPD and the medical staff who care for them to adapt the program for electronic delivery. Then, the program will be pilot-tested. Smokers with COPD will be randomly assigned to either usual medical care or the outreach intervention, with goals to increase participation in smoking cessation programs, quit attempts, and successful cessation.

Detailed Description: Chronic obstructive pulmonary disease (COPD) is one of the most common respiratory conditions and the 4th leading cause of death in the US. 90% of cases are directly attributable to smoking. Quitting smoking is the most important intervention for these patients, who continue to smoke at rates double the national average. Smokers with COPD remain undertreated for tobacco use. Proactive tobacco treatment programs identify patients outside of a routine clinic visit, engage them in making a quit attempt and connect them with treatment. These programs may be particularly beneficial for smokers with COPD. Previous phone-based programs are resource intensive to deliver. Electronic methods for delivering proactive outreach for tobacco cessation may be effective and cost-effective, and can be tailored to the target population.

Hypothesis: A proactive tobacco treatment program delivered electronically and tailored to smokers with COPD will be effective and cost effective for increasing quit engagement among smokers with COPD.

Study design: Multi-aim implementation study with randomized pilot. Aim 1: Mixed methods (survey and interview) assessment of current use of health information technology among smokers with COPD with a focus on the impact of the chronic disease state on tobacco cessation.

Aim 2: Qualitative assessment of barriers and facilitators to implementation of proactive tobacco treatment programs for patients with COPD among staff and leadership.

Aim 3: Randomized pilot of a proactive tobacco treatment program for smokers with COPD delivered through text messaging.

Recruitment & Eligibility

Status: COMPLETED

Sex: All

Target Recruitment: 124

Inclusion Criteria

Veterans active in clinical care (at least one primary care or pulmonary visit within the past year)
Past-year smoking status in the electronic health record indicating current smoking, confirmed on enrollment call
Diagnosed with COPD (2 International Classification of Diseases (ICD)-10 diagnoses of COPD within the past 2 years)
Currently enrolled in MyHealtheVet secure messaging

Exclusion Criteria

Already enrolled in behavioral VA tobacco treatment
Enrolled in hospice
Undergoing active cancer treatment
Advanced dementia
Unable to communicate in English

Study & Design

Study Type: INTERVENTIONAL

Study Design: PARALLEL

Primary Outcome Measures

Name	Time	Method
Participation in Tobacco Cessation Treatment	6 months	Any participation in tobacco cessation treatment (medication use, counseling)

Secondary Outcome Measures

Name	Time	Method
Moved Upward on the Quit Ladder	6 months	Count of participants who indicated that they were more interested in quitting smoking than at baseline
Types of Assistance Used	6 months	count of the types of assistance participants used
Medications Used	6 months	count of participant split by tobacco treatment medications used during quit attempts
7-day Abstinence	6 months	Count of participants who have not smoked in the past 7 days
Cut Down in Heaviness of Smoking	6 months	Cut down by 10 cigarettes per day or in frequency of smoking from daily to some days
Care Coordination	60 days	Proportion of participants who completed a care coordination call
Number of Quit Attempts	6 months	Self-reported attempts to quit smoking
30-Day Abstinence	6 months	Number of participants who had not smoked any cigarettes in the past 30 days
Quit or Cut Down	6 months	Number of participants who have either not smoked in the past 7 days or have cut down in heaviness or frequency

Trial Locations

Locations (1): Minneapolis VA Health Care System, Minneapolis, MN
🇺🇸
Minneapolis, Minnesota, United States
Minneapolis VA Health Care System, Minneapolis, MN
🇺🇸Minneapolis, Minnesota, United States