Trial Protocol: Using genotype to tailor prescribing of nicotine replacement therapy: a randomised controlled trial assessing impact of communication upon adherence

BMC Public Health

Study Protocol

Elaine C Johnstone¹  Marcus R Munafò²  A Toby Prevost³  David Armstrong³  Alison J Wright³  Gareth J Hollands⁴  Theresa M Marteau⁴  Chloe Hill⁴  Rachel A Crockett⁴  Sophia Whitwell⁴  Thomas A Willis⁴  Paul Aveyard⁵  Ann Louise Kinmonth⁶  Stephen Sutton⁶ 

[1] Department of Clinical Pharmacology, Old Road Campus Research Building, University of Oxford, Old Road Campus, OX3 7DQ, Headington, Oxford, UK;Department of Experimental Psychology, University of Bristol, 12a Priory Road, BS8 1TU, Bristol, UK;Department of Primary Care and Public Health Sciences, King's College London, 5th Floor Capital House, 42 Weston Street, SE1 3QD, London, UK;King's College London, Psychology Department (at Guy's), Health Psychology Section, 5th Floor Bermondsey Wing, Guy's Campus, SE1 9RT, London, UK;Primary Care Clinical Sciences, University of Birmingham, B15 2TT, Birmingham, UK;University of Cambridge Department of Public Health and Primary Care, Forvie Site, Robinson Way, CB2 0SR, Cambridge, UK;

关键词: Nicotine;    Smoking Cessation;    National Health Service;    Nicotine Dependence;    Nicotine Replacement Therapy;   

DOI  :  10.1186/1471-2458-10-680

 received in 2010-09-29, accepted in 2010-11-09,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundThe behavioural impact of pharmacogenomics is untested; informing smokers of genetic test results for responsiveness to smoking cessation medication may increase adherence to this medication. The objective of this trial is to estimate the impact upon adherence to nicotine replacement therapy (NRT) of informing smokers that their oral dose of NRT has been tailored to a DNA analysis. Hypotheses to be tested are as follows:IAdherence to NRT is greater among smokers informed that their oral dose of NRT is tailored to an analysis of DNA (genotype), compared to one tailored to nicotine dependence questionnaire score (phenotype).II Amongst smokers who fail to quit at six months, motivation to make another quit attempt is lower when informed that their oral dose of NRT was tailored to genotype rather than phenotype.Methods/DesignAn open label, parallel groups randomised trial in which 630 adult smokers (smoking 10 or more cigarettes daily) using National Health Service (NHS) stop smoking services in primary care are randomly allocated to one of two groups:i. NRT oral dose tailored by DNA analysis (OPRM1 gene) (genotype), orii. NRT oral dose tailored by nicotine dependence questionnaire score (phenotype)The primary outcome is proportion of prescribed NRT consumed in the first 28 days following an initial quit attempt, with the secondary outcome being motivation to make another quit attempt, amongst smokers not abstinent at six months. Other outcomes include adherence to NRT in the first seven days and biochemically validated smoking abstinence at six months. The primary outcome will be collected on 630 smokers allowing sufficient power to detect a 7.5% difference in mean proportion of NRT consumed using a two-tailed test at the 5% level of significance between groups. The proportion of all NRT consumed in the first four weeks of quitting will be compared between arms using an independent samples t-test and by estimating the 95% confidence interval for observed between-arm difference in mean NRT consumption (Hypothesis I). Motivation to make another quit attempt will be compared between arms in those failing to quit by six months (Hypothesis II).DiscussionThis is the first clinical trial evaluating the behavioural impact on adherence of prescribing medication using genetic rather than phenotypic information. Specific issues regarding the choice of design for trials of interventions of this kind are discussed.Trial detailsFunder: Medical Research Council (MRC)Grant number: G0500274ISRCTN: 14352545Date trial stated: June 2007Expected end date: December 2009Expected reporting date: December 2010

【 授权许可】

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