Integrating Tobacco Treatment into Cancer Care

将烟草治疗纳入癌症治疗

• 批准号: 9114049
• 负责人: Elyse R. Park
• 金额: $ 69.49万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-09-03 至 2018-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9114049
• 关键词: Abstinence; Address; Adopted; Age; American Society of Clinical Oncology; Belief; Cancer Center; Cancer Patient; Cancer Survivor; Caring; Characteristics; Chronic Disease; Clinic; Colon Carcinoma; Communication; Comprehensive Cancer Center; Controlled Clinical Trials; Counseling; Diagnosis; Diagnostic Neoplasm Staging; Disease; Effectiveness; Electronic Health Record; Enrollment; Evaluation; FDA approved; Gender; General Hospitals; Guidelines; Health; Household; Informal Social Control; Malignant Neoplasms; Malignant neoplasm of lung; Malignant neoplasm of prostate; Massachusetts; Medical; Memorial Sloan-Kettering Cancer Center; Modeling; Newly Diagnosed; Nicotine Dependence; Outcome; Pain; Patient Self-Report; Patients; Pharmaceutical Preparations; Pilot Projects; Policies; Prevalence; Primary Neoplasm; Provider; Quality Indicator; Quality of life; Radiosurgery; Randomized; Readiness; Recording of previous events; Recurrence; Reporting; Risk; Risk Factors; Second Primary Cancers; Self Efficacy; Site; Smoke; Smoker; Smoking; Smoking History; Survival Rate; System; Time; Tobacco; Treatment Effectiveness; Treatment outcome; United States Dept. of Health and Human Services; United States Public Health Service; Visit; anxiety symptoms; behavior change; brief intervention; cancer care; cancer diagnosis; cancer therapy; chemotherapy; collaborative care; comparative effectiveness; compare effectiveness; craving; depressive symptoms; dissemination research; effectiveness trial; efficacy trial; emotional distress; evidence base; follow-up; health belief; implementation research; improved; malignant breast neoplasm; meetings; modifiable risk; oncology; physical symptom; prospective; psychosocial; response; smoking cessation; social; socioeconomics; symposium; theories; tobacco abstinence; treatment group; varenicline

DESCRIPTION (provided by applicant): In response to the Dissemination and Implementation Research in Health PAR 10-38, we propose to examine the integration of two evidence-based tobacco treatments into real-world cancer care settings. Quitting smoking after cancer diagnosis may increase patients' quality of life and improve treatment outcomes through decreases in complications from surgery, radiation or chemotherapy, and decreases in risk of second primary tumors. At diagnosis, approximately 10-30% of cancer patients are smokers, and many have elevated socioeconomic, biologic, and psychosocial vulnerabilities. The U.S. Department of Health and Human Services Public Health Service has evidence-based tobacco treatment guidelines, but these have not been integrated into cancer care. An American Society of Clinical Oncology core quality indicator is identification, advice, and counseling of all smokers by their second cancer visit, but these quality standards are not being met. To address this treatment gap, we propose to conduct the first comparative effectiveness trial to assess the effectiveness of two evidence-based tobacco treatments among newly diagnosed cancer patients. Our proposal is guided by Dr. Park's findings from a nonrandomized controlled pilot study (5R03CA130722-02) which showed promising feasibility and efficacy for delivering an evidence-based Intensive Treatment (IT) to newly diagnosed lung cancer patients at Massachusetts General Hospital (MGH). We propose to enroll 295 current smokers newly diagnosed with lung, colon, breast, or prostate cancer (the four most prevalent cancers) at MGH and Memorial Sloan Kettering Cancer Center (MSK) and compare the differential effectiveness of delivering an Intensive Treatment (IT; 10 motivational counseling sessions plus 12 weeks of FDA approved smoking cessation medication) versus a Brief Treatment (BT; the current treatment provided at MSK, which is 4 motivational counseling sessions plus medication advice). Aim 1 will compare the effectiveness of the two tobacco treatments in promoting biochemically confirmed tobacco abstinence at 6 months. Aim 2 will assess mechanisms through which treatment promotes abstinence, subpopulations in which abstinence is promoted, and aspects of treatment that promote abstinence. Aim 3 will explore how many smokers enroll in, and adhere to, tobacco treatment. This proposal is unique in its 1) theory [(combining a chronic illness (Self-Regulation) and behavior change (Health Belief) model)], 2) integrated tobacco treatments (targeted to patients undergoing cancer treatment), and 3) collaborative care model (sustainable and facilitated through state-of- the art electronic health record systems). Study findings will addres previously unanswered questions about provision of integrated tobacco treatment as part of comprehensive cancer care. Furthermore, it will provide information to lay the groundwork for dissemination efforts into a variety of cancer care settings.

描述（由申请人提供）：为了响应健康 PAR 10-38 的传播和实施研究，我们建议研究将两种循证烟草治疗方法整合到现实世界的癌症护理环境中。癌症诊断后戒烟可以通过减少手术、放疗或化疗的并发症以及降低第二原发肿瘤的风险来提高患者的生活质量并改善治疗结果。在诊断时，大约 10-30% 的癌症患者是吸烟者，许多人的社会经济、生物和心理社会脆弱性较高。美国卫生与公众服务部公共卫生服务部制定了基于证据的烟草治疗指南，但尚未纳入癌症治疗。美国临床肿瘤学会的核心质量指标是在第二次癌症就诊时对所有吸烟者进行识别、建议和咨询，但这些质量标准并未得到满足。为了解决这一治疗差距，我们建议进行首次比较有效性试验，以评估两种循证烟草治疗在新诊断的癌症患者中的有效性。我们的提案以 Park 博士的非随机对照试点研究 (5R03CA130722-02) 的结果为指导，该研究显示了为马萨诸塞州总医院 (MGH) 新诊断的肺癌患者提供循证强化治疗 (IT) 的可行性和有效性。我们建议在 MGH 和纪念斯隆凯特琳癌症中心 (MSK) 招募 295 名新诊断患有肺癌、结肠癌、乳腺癌或前列腺癌（四种最常见癌症）的当前吸烟者，并比较提供强化治疗 (IT; 10 次动机咨询课程加上 12 周 FDA 批准的戒烟药物）与简短治疗（BT；MSK 目前提供的治疗，即 4 次动机咨询课程加上药物建议）。目标 1 将比较两种烟草治疗在促进 6 个月时生化证实的戒烟方面的有效性。目标 2 将评估治疗促进禁欲的机制、促进禁欲的亚人群以及促进禁欲的治疗方面。目标 3 将探讨有多少吸烟者参加并坚持烟草治疗。该提案的独特之处在于其1）理论[（结合慢性病（自我调节） 和行为改变（健康信念）模型）]，2）综合烟草治疗（针对正在接受癌症治疗的患者），以及 3）协作护理模型（可持续并通过最先进的电子健康记录系统促进）。研究结果将解决以前未解答的有关提供综合烟草治疗作为综合癌症护理一部分的问题。此外，它将提供信息，为各种癌症护理机构的传播工作奠定基础。

项目成果

Internalized stigma among cancer patients enrolled in a smoking cessation trial: The role of cancer type and associations with psychological distress.

参加戒烟试验的癌症患者的内在耻辱：癌症类型的作用及其与心理困扰的关联。

• 发表时间: 2022-05
• 影响因子: 3.6
• 作者: Warner, Erica T;Park, Elyse R;Luberto, Christina M;Rabin, Julia;Perez, Giselle K;Ostroff, Jamie S
• 通讯作者: Ostroff, Jamie S

Electronic cigarette use patterns and reasons for use among smokers recently diagnosed with cancer.

最近被诊断患有癌症的吸烟者的电子烟使用模式和使用原因。

• 发表时间: 2018-07
• 影响因子: 4
• 作者: Kalkhoran, Sara;Kruse, Gina R;Rigotti, Nancy A;Rabin, Julia;Ostroff, Jamie S;Park, Elyse R
• 通讯作者: Park, Elyse R

Smoking Behaviors Among Black and Hispanic Cancer Patients: A Systematic Review of the Literature.

黑人和西班牙裔癌症患者的吸烟行为：文献的系统回顾。

• 发表时间: 2023-08
• 作者: Rabin, Julia;Castelin, Stephanie;Strauss, Nicole;Philpotts, Lisa L;Park, Elyse R;Perez, Giselle
• 通讯作者: Perez, Giselle

Integrating tobacco treatment into cancer care: Study protocol for a randomized controlled comparative effectiveness trial.

将烟草治疗纳入癌症护理：随机对照比较有效性试验的研究方案。

• 发表时间: 2016-09
• 影响因子: 2.2
• 作者: Park, Elyse R;Ostroff, Jamie S;Perez, Giselle K;Hyland, Kelly A;Rigotti, Nancy A;Borderud, Sarah;Regan, Susan;Muzikansky, Alona;Friedman, Emily R;Levy, Douglas E;Holland, Susan;Eusebio, Justin;Peterson, Lisa;Rabin, Julia;Miller
• 通讯作者: Miller

Patient-Level Factors Associated with Oncology Provider-Delivered Brief Tobacco Treatment Among Recently Diagnosed Cancer Patients.

与肿瘤医生在最近诊断的癌症患者中提供的短期烟草治疗相关的患者层面因素。

• 发表时间: 2020
• 影响因子: 2.2
• 作者: Neil, J M;Price, S N;Friedman, E R;Ponzani, C;Ostroff, J S;Muzikansky, A;Park, E R
• 通讯作者: Park, E R