Electronic Proactive Outreach for Smokers With COPD: Engaging Patients to Quit (CDA 19-081)
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 124
- 试验地点
- 1
- 主要终点
- Participation in Tobacco Cessation Treatment
研究概览
简要总结
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.
详细描述
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.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Health Services Research
- 盲法
- Single (Outcomes Assessor)
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •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
排除标准
- •Already enrolled in behavioral VA tobacco treatment
- •Enrolled in hospice
- •Undergoing active cancer treatment
- •Advanced dementia
- •Unable to communicate in English
研究组 & 干预措施
Usual Care
Randomly assigned sample who will receive usual care for tobacco cessation treatment
Proactive Outreach
Randomly assigned sample who will receive a proactive offer of tobacco treatment with connection to motivational texting program.
干预措施: Proactive Outreach (Behavioral)
结局指标
主要结局
Participation in Tobacco Cessation Treatment
时间窗: 6 months
Any participation in tobacco cessation treatment (medication use, counseling)
次要结局
- Care Coordination(60 days)
- 30-Day Abstinence(6 months)
- Quit or Cut Down(6 months)
- Moved Upward on the Quit Ladder(6 months)
- Types of Assistance Used(6 months)
- Medications Used(6 months)
- 7-day Abstinence(6 months)
- Cut Down in Heaviness of Smoking(6 months)
- Number of Quit Attempts(6 months)