Optimizing Smoking Cessation for People With HIV/AIDS Who Smoke
试验速览
- 阶段
- 3 期
- 状态
- 已完成
- 入组人数
- 184
- 试验地点
- 1
- 主要终点
- Number of Participants With 7-day Point Prevalence Abstinence at 36 Weeks
研究概览
简要总结
The single greatest health behavior change that could improve cardiovascular morbidity and associated mortality is to assist people living with HIV/AIDS who smoke to quit. The investigators will use a factorial design to evaluate the most promising behavioral and pharmacologic treatments aimed at achieving maximal efficacy for smoking cessation among people living with HIV/AIDS who smoke. Results of this study will provide crucial, real world evidence of the best way for healthcare providers to help smokers living with HIV/AIDS quit smoking.
详细描述
The study used a factorial design to randomize participants into 4 conditions: (1) Varenicline (12 weeks) + Positively Smoke Free (PSF) (8 weeks); (2) Varenicline (12 weeks) + Standard of Care (brief advice to quit); (3) Placebo (12 weeks) + Positively Smoke Free (8 weeks); and (4) Placebo (12 weeks) + Standard of Care. The primary outcome was the 7-day point prevalence abstinence (PPA) (<10mm) at 36 weeks.
The specific aims of our proposal are:
Primary Aim 1: Compare varenicline to placebo on rates of 7-day point prevalence abstinence (PPA) at 36 weeks in smokers with HIV/AIDS. We hypothesize that rates of smoking abstinence at week 36 will be higher in those treated with varenicline compared to placebo.
Primary Aim 2: Compare Positively Smoke Free to low intensity, brief counseling on rates of 7-day PPA at 36 weeks in smokers with HIV/AIDS. We hypothesize that rates of smoking abstinence at week 36 will be higher in those treated with Positively Smoke Free compared to brief counseling.
Primary Aim 3: Compare Positively Smoke Free + varenicline to the other two study conditions outlined above on rates of 7-day PPA in smokers with HIV/AIDS at 36 weeks. We hypothesize the effect of PSF with varenicline is greater than the effect of PSF or varenicline alone.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Factorial
- 主要目的
- Treatment
- 盲法
- Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
入排标准
- 年龄范围
- 18 Years 至 65 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Confirmed chart diagnosis of a HIV and receiving HIV treatment at the participating HIV clinic.
- •Age 18 years or older.
- •Currently self-report smoking 10 cigarettes per day
- •Motivation to quit within the next 6 months (score 5-8 on the Abrams and Briener Readiness to Quit Ladder);
- •Does not meet criteria for current Diagnostic Statistical Manual (DSM) 5 moderate or severe alcohol use disorder or moderate or severe substance use disorder as established by the Mini Neuropsychiatric Interview (MINI) drug and alcohol sections (in the last 3 months)
- •Able to read and speak English
- •Willingness and ability to provide informed consent to participate.
排除标准
- •The exclusion criteria are designed to maximize safety by minimizing drug interactions or worsening pre-existing comorbid psychiatric or medical conditions:
- •Current suicidal thoughts or ideation (past week); recent suicidal thoughts or ideation (past 6 months) or recent suicide attempt (past 6 months) as assessed by the Columbia-Suicide Severity Rating Scale (C-SSRS).
- •Previous allergic reaction or hypersensitivity to Varenicline (by participant report ever in lifetime)
- •Pregnant, nursing, or becoming pregnant during the study (pregnancy test).
- •Current use of any medication that would interfere with the protocol in the opinion of Medically Accountable Physician including use of bupropion targeting nicotine dependence
- •Moderate to severe renal impairment (< 30 mL/min)--As determined by a physician assessment, chart review or thru blood work
- •Unstable cardiovascular disease (myocardial infarction within past year, uncontrolled arrhythmia, uncontrolled angina, uncontrolled congestive heart failure, electrocardiogram abnormality with QTC > 500 msec, cerebrovascular event within past year). (As determined by a physician assessment, chart review and/or EKG)
- •Meets criteria for dementia by scoring below 10 on the Hopkins HIV Dementia Scale. This criterion is included to ensure the sample consists of participants who are cognitively able to engage in the study procedures
- •Scores <5 ppm of expired carbon monoxide (CO) on the Smokelyzer
- •The study physician believes that the individual is not medially stable enough to participate in the study. This exclusion will be based on a review of the individual's past medical history and current medical status.
- •Recent use of Varenicline (by participant report in the past 3 months)
研究组 & 干预措施
Varenicline and Standard of Care
Participants will receive varenicline and standard of care
干预措施: Varenicline (Drug)
Varenicline and Standard of Care
Participants will receive varenicline and standard of care
干预措施: Standard of Care (Behavioral)
Placebo and Standard of Care
Participants will receive placebo and standard of care
干预措施: Placebo (Drug)
Placebo and Standard of Care
Participants will receive placebo and standard of care
干预措施: Standard of Care (Behavioral)
Positively Smoke Free and Placebo
Participant will receive Positively Smoke Free (a tailored behavioral intervention) and Placebo
干预措施: Positively Smoke Free (Behavioral)
Positively Smoke Free and Placebo
Participant will receive Positively Smoke Free (a tailored behavioral intervention) and Placebo
干预措施: Placebo (Drug)
Positively Smoke Free and Varenicline
Participant will receive Positively Smoke Free (a tailored behavioral intervention) and Varenicline
干预措施: Varenicline (Drug)
Positively Smoke Free and Varenicline
Participant will receive Positively Smoke Free (a tailored behavioral intervention) and Varenicline
干预措施: Positively Smoke Free (Behavioral)
结局指标
主要结局
Number of Participants With 7-day Point Prevalence Abstinence at 36 Weeks
时间窗: 36 weeks
7-day point-prevalence abstinence based onno self-reported tobacco use (not even a puff) during the 7 days preceding the assessment and a CO ≤10ppm as measured by Covita micro smokrlyzer at week 36.
次要结局
未报告次要终点
研究者
Deanna Kelly
Professor of Psychiatry
University of Maryland, Baltimore