Dissemination of the nurse-administered Tobacco Tactics intervention versus usual care in six Trinity community hospitals: study protocol for a comparative effectiveness trial

Trials

Andrea H Waltje²  Lee A Ewing³  Gay L Landstrom¹  Patricia L Thomas¹  Neil Jordan⁴  Frederic C Blow⁵  Marita G Titler²  David L Ronis³  Sonia A Duffy³ 

[1]Trinity Health, 34605 Twelve Mile Road, Farmington Hills, MI 48331-3221, USA

[2]School of Nursing, University of Michigan, 400 North Ingalls Building, Ann Arbor, MI 48109-5482, USA

[3]VA Center for Clinical Management Research, 2215 Fuller Road, Ann Arbor, MI 48105, USA

[4]Center for Management of Complex Chronic Care, Hines VA Hospital, 5000 South Fifth Ave, Hines, IL 60141, USA

[5]Department of Psychiatry, University of Michigan, Rachel Upjohn Building, 4250 Plymouth Road, Ann Arbor, MI 48109-2700, USA

关键词: Inpatient;    Cessation;    Smoking;   

Others  :  1095432
DOI  :  10.1186/1745-6215-13-125

 received in 2011-10-03, accepted in 2012-06-08,  发布年份 2012

【 摘 要 】

Background

The objectives of this smoking cessation study among hospitalized smokers are to: 1) determine provider and patient receptivity, barriers, and facilitators to implementing the nurse-administered, inpatient Tobacco Tactics intervention versus usual care using face-to-face feedback and surveys; 2) compare the effectiveness of the nurse-administered, inpatient Tobacco Tactics intervention versus usual care across hospitals, units, and patient characteristics using thirty-day point prevalence abstinence at thirty days and six months (primary outcome) post-recruitment; and 3) determine the cost-effectiveness of the nurse-administered, inpatient Tobacco Tactics intervention relative to usual care including cost per quitter, cost per life-year saved, and cost per quality-adjusted life-year saved.

Methods/Design

This effectiveness study will be a quasi-experimental design of six Michigan community hospitals of which three will get the nurse-administered Tobacco Tactics intervention and three will provide their usual care. In both the intervention and usual care sites, research assistants will collect data from patients on their smoking habits and related variables while in the hospital and at thirty days and six months post-recruitment. The intervention will be integrated into the experimental sites by a research nurse who will train Master Trainers at each intervention site. The Master Trainers, in turn, will teach the intervention to all staff nurses. Research nurses will also conduct formative evaluation with nurses to identify barriers and facilitators to dissemination.

Descriptive statistics will be used to summarize the results of surveys administered to nurses, nurses’ participation rates, smokers’ receipt of specific cessation services, and satisfaction with services. General estimating equation analyses will be used to determine differences between intervention groups on satisfaction and quit rates, respectively, with adjustment for the clustering of patients within hospital units. Regression analyses will test the moderation of the effects of the interventions by patient characteristics. Cost-effectiveness will be assessed by constructing three ratios including cost per quitter, cost per life-year saved, and cost per quality-adjusted life-year saved.

Discussion

Given that nurses represent the largest group of front-line providers, this intervention, if proven effective, has the potential for having a wide reach and thus decrease smoking, morbidity and mortality among inpatient smokers.

Trial registration

Dissemination of Tobacco Tactics for Hospitalized Smokers NCT01309217

【 授权许可】

   
2012 Duffy et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]Freund M, Campbell E, Paul C, Sakrouge R, McElduff P, Walsh RA, Wiggers J, Knight J, Girgis A: Increasing smoking cessation care provision in hospitals: a meta-analysis of intervention effect. Nicotine Tob Res 2009, 11:650-662.
• [2]Rice VH, Stead LF: Nursing interventions for smoking cessation. Cochrane Database Syst Rev 2004, (1):CD001188.
• [3]Duffy SA, Reeves P, Hermann C, Karvonen C, Smith P: In-hospital smoking cessation programs: what do VA patients and staff want and need? Appl Nurs Res 2008, 21:199-206.
• [4]Duffy SA, Ronis DL, Valenstein M, Lambert MT, Fowler KE, Gregory L, Bishop C, Myers LL, Blow FC, Terrell JE: A tailored smoking, alcohol, and depression intervention for head and neck cancer patients. Cancer Epidemiol Biomarkers Prev 2006, 15:2203-2208.
• [5]Duffy SA, Karvonen-Gutierrez CA, Ewing LA, Smith PM, Veterans Integrated Services Network (VISN) 11 Tobacco Tactics Team: Implementation of the Tobacco Tactics Program in the Department of Veterans Affairs. J Gen Intern Med 2010, (Suppl 1):3-10.
• [6]Weinreich N: What is Social Marketing?. http://www.social-marketing.com/Whatis.html webcite
• [7]Design of quasi-experiments. http://en.wikipedia.org/wiki/Design_of_quasi-experiments webcite
• [8]Quasi-experimental and experimental designs: more powerful evaluation designs. http://ssmon.chb.kth.se/safebk/Chp_4.pdf webcite
• [9]Terrell JE, Ronis DL, Fowler KE, Bradford CR, Chepeha DB, Prince ME, Teknos TN, Wolf GT, Duffy SA: Clinical predictors of quality of life in patients with head and neck cancer. Arch Otolaryngol Head Neck Surg 2004, 130:401-408.
• [10]Duffy SA, Ronis DL, Valenstein M, Fowler KE, Lambert MT, Bishop C, Terrell JE: Depressive symptoms, smoking, drinking, and quality of life among head and neck cancer patients. Psychosomatics 2007, 48:142-148.
• [11]Dillman DA: Mail and Telephone Surveys: The Total Design Method. John Wiley & Sons, New York; 1978.
• [12]Faseru B, Turner M, Casey G, Ruder C, Befort CA, Ellerbeck EF, Richter KP: Evaluation of a hospital-based tobacco treatment service: outcomes and lessons learned. J Hosp Med 2011, 6:211-218.
• [13]Regan S, Reyen M, Lockhart AC, Richards AE, Rigotti NA: An interactive voice response system to continue a hospital-based smoking cessation intervention after discharge. Nicotine Tob Res 2011, 13(4):255-260.
• [14]Thomson O'Brien MA, Freemantle N, Oxman AD, Wolf F, Davis DA, Herrin J: Continuing education meetings and workshops: effects on professional practice and health care outcomes (review). Cochrane Database Syst Rev 2001, (2):CD003030.
• [15]Bandura A: Social Foundations of Thought and Action: A Social-Cognititve Theory. Prentice Hall, Englewood Cliffs, NJ; 1986.
• [16]Marlatt GA, Gordon JR: Relapse Prevention: Maintenance Strategies in the Treatment of Addiction. Guilford Press, New York; 1985.
• [17]Kottke TE, Battista RN, DeFriese GH, Brekke ML: Attributes of successful smoking cessation interventions in medical practice. A meta-analysis of 39 controlled trials. JAMA 1988, 259:2883-2889.
• [18]Fiore MC, Jaén CR, Baker TB, Bailey WC, Benowitz NL, Curry SJ, Dorfman SF, Froelicher ES, Goldstein MG, Healton CG, Henderson PN, Heyman RB, Koh HK, Kottke TE, Lando HA, Mechlenburg RE, Mermelstein RJ, Mullen PD, Orleans CT, Robinson L, Stitzer ML, Tommasello AC, Villejo L, Wewers ME: Treating Tobacco Use and Dependence: 2008 Update. U.S. Department of Health and Human Services. Public Health Service, Rockville, MD; 2008.
• [19]Lancaster T, Stead L: Physician advice for smoking cessation. Cochrane Database Syst Rev 2004, (4):CD000165.
• [20]An LC, Zhu SH, Nelson DB, Arikian NJ, Nugent S, Partin MR, Joseph AM: Benefits of telephone care over primary care for smoking cessation: a randomized trial. Arch Intern Med 2006, 166:536-542.
• [21]Lichtenstein E, Glasgow RE, Lando HA, Ossip-Klein DJ, Boles SM: Telephone counseling for smoking cessation: rationales and meta-analytic review of evidence. Health Educ Res 1996, 11:243-257.
• [22]Smith PM, Cameron R, McDonald PW, Kawash B, Madill C, Brown KS: Telephone counseling for population-based smoking cessation. Am J Health Behav 2004, 28:231-241.
• [23]Lawrence K, Heisler M, Resnicow K, Halasyamani L, Mase R, Monroe M: Tools for Being a Helpful Peer Partner (video recording). In Supported by the National Heart Lung, and Blood Institute. Developed by the University of Michigan and St Joseph Mercy Health System. The Regents of the University of Michigan, Ann Arbor; 2007.
• [24]Thompson BT, Schoenfeld D: Usual care as the control group in clinical trials of nonpharmacologic interventions. Proc Am Thorac Soc 2007, 4:577-582.
• [25]Tobacco Free Nurses Initiative: Tobacco Free Nurses Fact Sheet on the Joint Commission on Accreditation of Healthcare Organization's (JCAHO) Smoking Cessation Counseling Performance Measures. http://www.tobaccofreenurses.org/media/documents/facts01print.pdf webcite
• [26]Perez-Rios M, Santiago-Perez MI, Alonso B, Malvar A, Hervada X, de Leon J: Fagerstrom test for nicotine dependence vs heavy smoking index in a general population survey. BMC Publ Health 2009, 9:493. BioMed Central Full Text
• [27]Lowe B, Kroenke K, Grafe K: Detecting and monitoring depression with a two-item questionnaire (PHQ-2). J Psychosom Res 2005, 58:163-171.
• [28]Bush K, Kivlahan DR, McDonell MB, Fihn SD, Bradley KA: The AUDIT alcohol consumption questions (AUDIT-C): an effective brief screening test for problem drinking. Ambulatory Care Quality Improvement Project (ACQUIP). Alcohol Use Disorders Identification Test. Arch Intern Med 1998, 158:1789-1795.
• [29]Dawson DA, Grant BF, Stinson FS, Zhou Y: Effectiveness of the derived Alcohol Use Disorders Identification Test (AUDIT-C) in screening for alcohol use disorders and risk drinking in the US general population. Alcohol Clin Exp Res 2005, 29:844-854.
• [30]Rabin R, de Charro F: EQ-5D: a measure of health status from the EuroQol Group. Ann Med 2001, 33:337-343.
• [31]Hardin JW, Hilbe JM: Generalized estimating equations. Chapman & Hall/CRC press, Boca Raton, FL; 2002.
• [32]Morel JG, Bokossa MC, Neerchal NK: Small sample correction for the variance of GEE estimators. Biom J 2003, 45:395-409.
• [33]Javitz HS, Swan GE, Zbikowski SM, Curry SJ, McAfee TA, Decker DL, Patterson R, Jack LM: Cost-effectiveness of different combinations of bupropion SR dose and behavioral treatment for smoking cessation: a societal perspective. Am J Manag Care 2004, 10:217-226.
• [34]Gold M, Siegel JE, Russell LB, Weinstein MC (Eds): Cost-Effectiveness in Health and Medicine. Oxford University Press, New York, NY; 1996.
• [35]Initial National Priorities for Comparative Effectiveness Research. http://www.iom.edu/Reports/2009/ComparativeEffectivenessResearchPriorities.aspx webcite
• [36]H.R. 1-111th Congress: American Recovery and Reinvestment Act of 2009. GovTrack.us (database of federal legislation). 2009 2009. http://www.govtrack.us/congress/bill.xpd?bill=h111-1 webcite
• [37]Benner JS, Morrison MR, Karnes EK, Kocot SL, McClellan M: An evaluation of recent federal spending on comparative effectiveness research: priorities, gaps, and next steps. Heal Aff 2010, 29:1768-1776.