Project 1: Optimizing Smoking Cessation Treatment in Primary Care: A Factorial Screening Experiment (Cessation Screening)

项目 1：优化初级保健中的戒烟治疗：析因筛选实验（戒烟筛选）

基本信息

批准号：
10627883
负责人：
Megan E Piper
金额：
$ 9.62万
依托单位：
UNIVERSITY OF WISCONSIN-MADISON
依托单位国家：
美国
项目类别：
财政年份：
2014
资助国家：
美国
起止时间：
2014-09-01 至 2025-04-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10627883
关键词：
Abstinence Address Advertisements Biochemical Caring Cause of Death Cessation of life Chronic Care Clinical Collaborations Counseling Data Decision Analysis Dependence Development Disease Effectiveness Evaluation Goals Health Care Visit Healthcare Individual Intervention Joints Knowledge Malignant Neoplasms Mediator Methodology Methods Modality Patients Persons Pharmaceutical Preparations Pharmacotherapy Population Preparation Prevalence Primary Care Randomized Randomized, Controlled Trials Recording of previous events Regimen Research Research Project Grants Sampling Self Efficacy Smoke Smoker Smoking Smoking Cessation Intervention Smoking treatment System Telephone Tobacco Tobacco Dependence Tobacco use Treatment Factor Visit Withdrawal World Health cost cost effective cost effectiveness design effective therapy efficacy trial experimental study health care settings improved innovation intervention effect multiphase optimization strategy nicotine replacement precision medicine premature primary care clinic primary care patient programs randomized, clinical trials recruit response screening sex smoking abstinence smoking cessation smoking prevalence standard care synergism theories treatment optimization treatment program treatment strategy varenicline virtual

项目摘要

Project Summary Tobacco use is the leading preventable cause of both premature deaths overall and cancer deaths in the US. Most smokers visit a healthcare setting each year, providing an unequaled opportunity to intervene. Yet, most smokers do not receive highly effective cessation treatment during their healthcare visits. To improve the effectiveness of smoking treatment in healthcare, this project will identify especially promising medication regimens and counseling modalities for use in primary care for the two most effective smoking cessation pharmacotherapies: varenicline and combination nicotine replacement therapy (C-NRT). The criteria for identifying promising varenicline and C-NRT treatments will include 1-year biochemically confirmed point- prevalence abstinence and cost. Smokers (N=608) from primary care clinics, who want to quit smoking, will be randomized to receive one of two levels of each of four factors: 1) Medication Type (Varenicline vs. C-NRT), 2) Preparation Medication (4 weeks vs. Standard), 3) Medication Duration (Extended [24 weeks] vs. Standard [12 weeks]), and 4) Counseling Modality (In-Person vs. Phone). The proposed research builds on our expertise and prior research findings to address a critical knowledge gap: i.e., how best to use the most effective smoking cessation pharmacotherapies in real-world healthcare settings. This research will use an efficient and innovative methodology (i.e., the Multiphase Optimization Strategy) to identify the most promising C-NRT and varenicline-based treatments to use with primary care patients who smoke. These especially promising (“optimized”) treatments will then be evaluated in a randomized clinical trial in the Optimized Care Project of this Program Project.

项目概要在美国，烟草使用是导致过早死亡和癌症死亡的首要可预防原因。大多数吸烟者每年都会去医疗机构就诊，这提供了无与伦比的干预机会。吸烟者在就诊期间没有接受高效的戒烟治疗。吸烟治疗在医疗保健中的有效性，该项目将确定特别有前途的药物用于初级保健的两种最有效戒烟方案和咨询方式药物治疗：伐尼克兰和联合尼古丁替代疗法（C-NRT）的标准。确定有前景的伐尼克兰和 C-NRT 治疗方法将包括 1 年的生化确认点- 想要戒烟的初级保健诊所的吸烟者 (N=608) 的戒烟率和费用。随机接受四个因素中每一个的两个水平之一：1) 药物类型（伐尼克兰与 C-NRT），2) 准备药物（4 周与标准），3) 药物持续时间（延长 [24 周] 与标准 [12 周] 周]），以及 4）咨询方式（面对面与电话）。拟议的研究建立在我们的专业知识之上。和先前的研究成果来解决一个关键的知识差距：即如何最好地使用最有效的这项研究将在现实世界的医疗保健环境中使用有效且有效的戒烟药物疗法。创新方法（即多阶段优化策略）来确定最有前途的 C-NRT 和基于伐尼克兰的治疗方法适用于吸烟的初级保健患者。（“优化”）治疗将在优化护理项目的随机临床试验中进行评估本计划项目。