Hospitalized Smokers

NCT01305928 | Completed

• 1 other identifier: 12345
• Study Type: interventional
• Target: 1,054
• Locations: 1 country
• Sites: 1

Brief Summary

Post-discharge support is a key component of effective treatment for hospitalized smokers, but very few hospitals provide it. Linking hospitalized smokers with free, proactive tobacco quitlines is an ideal way to provide supportive contact at discharge, because quitlines are effective and cost effective for smoking cessation. Many hospitals are beginning to fax-refer smokers to quitlines at discharge. Fax referral is convenient and is part of the current culture of medical communication channels. However, less than half of fax-referred smokers are successfully contacted and enrolled in quitline services. "Warm hand-off" is a novel approach to care transitions in which health care providers directly link patients that have substance abuse and mental health problems with specialists, using face-to-face or phone transfer. Warm hand-off achieves very high rates of treatment enrollment for these highly vulnerable groups.

Conditions

Hospitalized Smokers

Outcome Measures

Primary Outcomes (1)

• 7-day point-prevalence, verified smoking cessation

  To test the effects of warm hand-off versus fax referral on smoking cessation

  up to 6 months

Secondary Outcomes (2)

• Enrollment in quitline services and adherence to quitline counseling sessions

  up to 6 months

• To examine the costs to providers and participants of the intervention and control conditions

  up to 6 months

Study Arms (2)

Fax

ACTIVE COMPARATOR

Other: Fax

Warm Hand-off

EXPERIMENTAL

Other: Warm Hand-off

Interventions

Warm Hand-off OTHER

Warm Hand-Off Staff brief intervention and warm hand-off (5 min): * Assess withdrawal, need for medication change * Describe warm hand-off process * Provide 2-page flyer * Perform call, leave room * Notify patients' nurse patient is talking to quitline Quitline session (20 min): * Collect minimum data set * Explore thoughts/feelings toward quitting * Provide medication education * Build plan to stay quit * Schedule next call Staff check-back (5 min): * Ask patient how session went * Ask if patient requests cessation medication script on discharge

Warm Hand-off

Fax OTHER

Fax Staff standard in-patient session: (30 minutes): * Assess withdrawal, need for medication change * Conduct assessment of smoking history, interest in quitting * Explore relevance, risks, rewards, and roadblocks (4Rs) related to smoking and quitting * Provide 2-page flyer * Provide medication education * Build plan to stay quit * Describe fax-referral process * Ask if patient requests cessation medication script on discharge

Fax

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• aged 18 years and older,
• have smoked at least 1 cigarette in the 30 days prior to admission,
• speak Spanish or English,
• and wish to remain abstinent after they are discharged
• Patients who are discharged to another facility (for long term care or rehabilitation) will be included in the trial.

You may not qualify if:

• acute life-threatening medical conditions (for example, cardiac arrest, acute respiratory failure, septic shock),
• communication barriers (intubation, unable to speak or hear),
• altered mental status,
• severe unstable psychiatric disorder (acute psychosis),
• terminal illness with less than a 12 month life expectancy
• non-Kansans because residents of other states may receive quitline services from a different vendor which would confound intervention effects and make it difficult to obtain quitline adherence data

Sponsors & Collaborators

• University of Kansas Medical Center: lead

Study Sites (1)

University of Kansas Medical Center

Kansas City, Kansas, 66160, United States

Location

Related Publications (8)

• Triant VA, Grossman E, Rigotti NA, Ramachandran R, Regan S, Sherman SE, Richter KP, Tindle HA, Harrington KF. Impact of Smoking Cessation Interventions Initiated During Hospitalization Among HIV-Infected Smokers. Nicotine Tob Res. 2020 Jun 12;22(7):1170-1177. doi: 10.1093/ntr/ntz168.

  PMID: 31687769 DERIVED

• Mussulman LM, Scheuermann TS, Faseru B, Nazir N, Richter KP. Rapid relapse to smoking following hospital discharge. Prev Med Rep. 2019 May 23;15:100891. doi: 10.1016/j.pmedr.2019.100891. eCollection 2019 Sep.

  PMID: 31193919 DERIVED

• Liebmann EP, Scheuermann TS, Faseru B, Richter KP. Critical steps in the path to using cessation pharmacotherapy following hospital-initiated tobacco treatment. BMC Health Serv Res. 2019 Apr 24;19(1):246. doi: 10.1186/s12913-019-4059-4.

  PMID: 31018852 DERIVED

• Scheuermann TS, Preacher KJ, Carlini BH, Bush T, Magnusson B, Nazir N, Richter KP. Predictors of engagement in post-discharge quitline counseling among hospitalized smokers. J Behav Med. 2019 Feb;42(1):139-149. doi: 10.1007/s10865-018-9951-6. Epub 2018 Jul 19.

  PMID: 30027388 DERIVED

• Mussulman LM, Faseru B, Fitzgerald S, Nazir N, Patel V, Richter KP. A randomized, controlled pilot study of warm handoff versus fax referral for hospital-initiated smoking cessation among people living with HIV/AIDS. Addict Behav. 2018 Mar;78:205-208. doi: 10.1016/j.addbeh.2017.11.035. Epub 2017 Nov 26.

  PMID: 29216569 DERIVED

• Richter KP, Faseru B, Shireman TI, Mussulman LM, Nazir N, Bush T, Scheuermann TS, Preacher KJ, Carlini BH, Magnusson B, Ellerbeck EF, Cramer C, Cook DJ, Martell MJ. Warm Handoff Versus Fax Referral for Linking Hospitalized Smokers to Quitlines. Am J Prev Med. 2016 Oct;51(4):587-96. doi: 10.1016/j.amepre.2016.04.006.

  PMID: 27647059 DERIVED

• Duffy SA, Cummins SE, Fellows JL, Harrington KF, Kirby C, Rogers E, Scheuermann TS, Tindle HA, Waltje AH; Consortium of Hospitals Advancing Research on Tobacco (CHART). Fidelity monitoring across the seven studies in the Consortium of Hospitals Advancing Research on Tobacco (CHART). Tob Induc Dis. 2015 Sep 3;13(1):29. doi: 10.1186/s12971-015-0056-5. eCollection 2015.

  PMID: 26336372 DERIVED

• Richter KP, Faseru B, Mussulman LM, Ellerbeck EF, Shireman TI, Hunt JJ, Carlini BH, Preacher KJ, Ayars CL, Cook DJ. Using "warm handoffs" to link hospitalized smokers with tobacco treatment after discharge: study protocol of a randomized controlled trial. Trials. 2012 Aug 1;13:127. doi: 10.1186/1745-6215-13-127.

  PMID: 22853047 DERIVED

Study Officials

• Kimber Richter, PhD

  University of Kansas Medical Center

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: SUPPORTIVE CARE
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associate Professor

Study Record Dates

• First Submitted: February 24, 2011
• First Posted: March 1, 2011
• Study Start: February 1, 2011
• Primary Completion: April 1, 2014
• Study Completion: January 1, 2016
• Last Updated: April 26, 2016

Record last verified: 2016-04

Data Sharing

• IPD Sharing: Will share

Locations

US (1)