Quit in General Practice: a cluster randomised trial of enhanced in-practice support for smoking cessation

BMC Family Practice

Study Protocol

Julie Smith¹  Ron Borland²  Oshana Hermiz³  John Furler⁴  Irene Blackberry⁴  Elizabeth Halcomb⁵  Nicholas Zwar⁶  Robyn Richmond⁶ 

[1] Australian Centre for Economic Research on Health, Australian National University Canberra, 0200, ACT, Australia;Cancer Council Victoria, 1 Rathdowne St, 3053, Carlton, Melbourne Vic, Australia;Centre for Primary Health Care and Equity, University of New South Wales, 2052, Sydney, NSW, Australia;Primary Care Research Unit, Department of General Practice, University of Melbourne, 200 Berkeley St, 3053, Carlton, Melbourne Victoria, Australia;School of Nursing and Midwifery, University of Western Sydney, Locked Bag 1797, 1797, Penrith South, Sydney, DC NSW, Australia;School of Public Health and Community Medicine, University of New South Wales, 2052, Sydney, NSW, Australia;

关键词: Smoking Cessation;    Nicotine Dependence;    Practice Nurse;    Computer Assist Telephone Interview;    Smoking Cessation Advice;   

DOI  :  10.1186/1471-2296-11-59

 received in 2010-05-14, accepted in 2010-08-12,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundThis study will test the uptake and effectiveness of a flexible package of smoking cessation support provided primarily by the practice nurse (PN) and tailored to meet the needs of a diversity of patients.Methods/DesignThis study is a cluster randomised trial, with practices allocated to one of three groups 1) Quit with Practice Nurse 2) Quitline referral 3) GP usual care. PNs from practices randomised to the intervention group will receive a training course in smoking cessation followed by access to mentoring. GPs from practices randomised to the Quitline referral group will receive information about the study and the process of written referral and GPs in the usual care group will receive information about the study. Eligible patients are those aged 18 and over presenting to their GP who are daily or weekly smokers and who are able to give informed consent. Patients on low incomes in all three groups will be able to access free nicotine patches.Primary outcomes are sustained abstinence and point prevalence abstinence at the three month and 12 month follow-up points; and incremental cost effectiveness ratios at 12 months. Process evaluation on the reach and acceptability of the intervention approached will be collected through Computer Assisted Telephone Interviews (CATI) with patients and semi-structured interviews with PNs and GPs.The primary analysis will be by intention to treat. Cessation outcomes will be compared between the three arms at three months and 12 month follow-up using multiple logistic regression. The incremental cost effectiveness ratios will be estimated for the 12 month quit rate for the intervention groups compared to usual care and to each other. Analysis of qualitative data on process outcomes will be based on thematic analysis.DiscussionHigh quality evidence on effectiveness of practice nurse interventions is needed to inform health policy on development of practice nurse roles. If effective, flexible support from the PN in partnership with the GP and the Quitline could become the preferred model for providing smoking cessation advice in Australian general practice.Trial RegistrationACTRN12609001040257

【 授权许可】

CC BY   
© Zwar et al; licensee BioMed Central Ltd. 2010