Smoking Interventions in General Medical Practices

NCT00679861 | Unknown Phase 2 DMC

• 1 other identifier: E2_P4, 01EB0420
• Study Type: interventional
• Target: 3,215
• Locations: 0 countries
• Sites: N/A

Brief Summary

Primary care physicians can play an important role in reducing tobacco smoking in the population. The general practice is a suitable setting for implementing proactive smoking interventions, because a large proportion of the population can be regularly reached in a favorable psychological state. Further, a trustful interpersonal relationship between the practitioners and their patients is supposed to increase the susceptibility to preventive measures. However, currently general practitioners are not capitalizing this advantage although evidence based treatments are available, which are effective and cost-effective. Outreach programs combining educational and practice-based measures have been found to be effective in engaging practitioners in screening and in giving advice. Computer expert-system and brief counseling interventions, which are based on the Transtheo-retical Model of behavior change (TTM), are promising approaches for the entire population of practitioners and smoking patients. For large scale implementation, data are needed about the degree of integration in every day routine clinical practice that could be achieved by implementing such interventions. Objectives: Evaluating different strategies for the implementation of proactive smoking interventions in general practices. Methods: In a randomized controlled trial, 150 randomly selected general practices of a defined German region will be included. The procedure comprises the implementation of 1) an on-site computer expert-system intervention, 2) a counseling intervention provided by the practitioner, or 3) the computer expert-system plus the counseling intervention. During an implementation phase of one month, two on site training sessions and support by phone will be provided. Routine use of the interventions will be monitored for the following 6 months. Main outcome measures are the number and rate of identified and treated smokers. A follow-up assessment will be realized 12 months after practice attendance to determine the smoking status of the treated smokers.

Conditions

Tobacco Smoking; Nicotine Dependence

Keywords

primary medical care; computer expert system; motivational interviewing; health behavior change counselling; stages of change

Outcome Measures

Primary Outcomes (2)

• Number of treated Patients by practice within study period

  7 months

• Point prevalence smoking abstinence of treated patients

  24 hours, 7 days, 4 weeks, 6 months preceeding the 12 months follow-up assessment

Secondary Outcomes (4)

• Participation rate of practices

  within recruitment phase

• Quit and cut down attempts of patients

  12 months

• number of cigarettes smoked per day

  4 weeks preceeding follow-up

• Stages of change progress

  at 12 month follow-up compared to baseline

Study Arms (3)

3

EXPERIMENTAL

A practitioner delivered counselling and an expert system intervention is implemented in practices allocated to this arm

Behavioral: Counselling Intervention; Behavioral: Expert-system intervention

1

EXPERIMENTAL

A practitioner delivered counselling intervention was implemented in practices allocated to this arm

Behavioral: Counselling Intervention

2

EXPERIMENTAL

A computer expert system intervention was implemented in practices allocated to this arm

Behavioral: Expert-system intervention

Interventions

Counselling Intervention BEHAVIORAL

A personal counselling by the residing practitioner of up to 10 minutes. A follow-up counselling is included for the next regular patient consultation

1; 3

Expert-system intervention BEHAVIORAL

Counselling letter of three to four pages will be generated by an expert-system base on the assessment of the patient. A second and third letter will be generated at follow-up consultations.

2; 3

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Practices with regular office hours
• Practices predominantly providing primary medical care for adults
• Patients with age 18 and older
• Patients with sufficient German language and cognitive capabilities to complete assessment
• Patients smoking within the preceding six month

You may not qualify if:

• Practices planing closure within the next 12 months
• Practices opening less than 12 months ago

Sponsors & Collaborators

• University Medicine Greifswald: lead
• German Federal Ministry of Education and Research: collaborator
• German Research Foundation: collaborator

MeSH Terms

Conditions

Tobacco Smoking; Tobacco Use Disorder

Condition Hierarchy (Ancestors)

Smoking; Behavior; Tobacco Use; Substance-Related Disorders; Chemically-Induced Disorders; Mental Disorders

Study Officials

• Christian Meyer, Dr.

  University of Greifswald

  PRINCIPAL INVESTIGATOR

• Ulrich John, Prof. Dr.

  University of Greifswald

  STUDY DIRECTOR

Study Design

• Study Type: interventional
• Phase: phase 2
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: CARE PROVIDER, OUTCOMES ASSESSOR
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: FACTORIAL
• Sponsor Type: OTHER

Study Record Dates

• First Submitted: May 15, 2008
• First Posted: May 19, 2008
• Study Start: October 1, 2004
• Primary Completion: August 1, 2008
• Study Completion: June 1, 2009
• Last Updated: May 19, 2008

Record last verified: 2008-05