Department of Medicine, Division of Pulmonary, Allergy & Critical Care Medicine, The University of Alabama at Birmingham (UAB), Birmingham, Alabama 35249-7337, USA.
Trials. 2012 Aug 1;13:123. doi: 10.1186/1745-6215-13-123.
E-health tools are a new mechanism to expand patient care, allowing supplemental resources to usual care, including enhanced patient-provider communication. These applications to smoking cessation have yet to be tested in a hospitalized patient sample. This project aims to evaluate the effectiveness and cost-effectiveness of a tailored web-based and e-message smoking cessation program for current smokers that, upon hospital discharge, transitions the patient to continue a quit attempt when home (Decide2Quit).
A randomized two-arm follow-up design will test the effectiveness of an evidence- and theoretically-based smoking cessation program designed for post-hospitalization.
A total of 1,488 patients aged 19 or older, who smoked cigarettes in the previous 30 days, are being recruited from 27 patient care areas of a large urban university hospital. Study-eligible hospitalized patients receiving usual tobacco cessation usual care are offered study referral. Trained hospital staff assist the 744 patients who are being randomized to the intervention arm with registration and orientation to the intervention website. This e-mail and web-based program offers tailored messages as well as education, self-assessment and planning aids, and social support to promote tobacco use cessation. Condition-blind study staff assess participants for tobacco use history and behaviors, tobacco use cost-related information, co-morbidities and psychosocial factors at 0, 3, 6, and 12 months. The primary outcome is self-reported 30-day tobacco abstinence at 6 months follow-up. Secondary outcomes include 7-day point prevalence quit rates at 3-, 6-, and 12-month follow-up, 30-day point prevalence quit rates at 3 and 12 months, biologically confirmed tobacco abstinence at 6-month follow-up, and multiple point-prevalence quit rates based on self-reported tobacco abstinence rates at each follow-up time period. Healthcare utilization and quality of life are assessed at baseline, and 6- and 12-month follow-up to measure program cost-effectiveness from the hospital, healthcare payer, patient, and societal perspectives.
Given the impact of tobacco use on medical resources, establishing feasible, cost-effective methods for reducing tobacco use is imperative. Given the minimal hospital staff burden and the automated transition to a post-hospitalization tailored intervention, this program could be an easily disseminated approach.
Current Intervention Trial NCT01277250.
电子健康工具是一种扩展患者护理的新机制，允许在常规护理之外提供补充资源，包括增强医患沟通。这些应用于戒烟的方法尚未在住院患者样本中进行测试。本项目旨在评估针对当前吸烟者的定制基于网络和电子信息的戒烟计划的有效性和成本效益，该计划在患者出院后将其过渡到在家中继续戒烟尝试（Decide2Quit）。
一项随机两臂随访设计将测试为住院后设计的基于证据和理论的戒烟计划的有效性。
共有 1488 名年龄在 19 岁或以上、在过去 30 天内吸烟的患者，从一家大型城市大学医院的 27 个患者护理区招募。符合条件的住院患者在接受常规烟草戒断常规护理的同时，也被提供研究推荐。经过培训的医院工作人员协助随机分配到干预组的 744 名患者注册并熟悉干预网站。该电子邮件和网络程序提供定制消息以及教育、自我评估和规划辅助工具以及社会支持，以促进烟草使用的戒断。条件盲研究人员在 0、3、6 和 12 个月时评估参与者的烟草使用史和行为、烟草使用成本相关信息、合并症和心理社会因素。主要结果是在 6 个月随访时自我报告的 30 天烟草戒断率。次要结果包括 3、6 和 12 个月随访时 7 天点患病率戒烟率、3 个月和 12 个月随访时 30 天点患病率戒烟率、6 个月随访时生物确认的烟草戒断率以及基于每个随访时间段自我报告的烟草戒断率的多个点患病率戒烟率。在基线时评估医疗保健利用情况和生活质量，并在 6 个月和 12 个月时进行评估，以从医院、医疗保健支付者、患者和社会角度衡量计划的成本效益。
鉴于烟草使用对医疗资源的影响，制定可行且具有成本效益的减少烟草使用的方法至关重要。鉴于医院工作人员的负担最小，并且可以自动过渡到住院后定制的干预措施，因此该计划可以作为一种易于传播的方法。
当前干预试验 NCT01277250。
