Design and participant characteristics of a randomized-controlled trial of telemedicine for smoking cessation among rural smokers

Mussulman, Laura M.; Ellerbeck, Edward F.; Cupertino, A. Paula; Preacher, Kristopher J.; Spaulding, Ryan; Catley, Delwyn; Cox, Lisa Sanderson; Lambart, Leah; Hunt, Jamie J.; Nazir, Niaman; Shireman, Theresa I.; Richter, Kimber P.

doi:10.1016/j.cct.2014.04.008

Cited by 17 publications

(18 citation statements)

References 30 publications

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“…Since the advent of US public awareness of health risks from smoking [ 7 ], many smokers who have been able to quit by using medications or other available therapies have already quit, leaving a population of smokers today that is more dependent [ 8 ], and more resistant to available therapies [ 9 ]. Smokers now are most highly represented within low socioeconomic status (SES) populations [ 4 , 10 ] who often have limited access to effective therapies [ 11 , 12 ]. As the population of smokers becomes resistant to available therapies [ 13 , 14 ] there is a growing need for new, effective therapies that can be made widely available, especially to disadvantaged populations [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

Mindfulness training for smokers via web-based video instruction with phone support: a prospective observational study

Davis

Manley

Goldberg

et al. 2015

BMC Complement Altern Med

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BackgroundMany smokers are unable to access effective behavioral smoking cessation therapies due to location, financial limitations, schedule, transportation issues or other reasons. We report results from a prospective observational study in which a promising novel behavioral intervention, Mindfulness Training for Smokers was provided via web-based video instruction with telephone-based counseling support.MethodsData were collected on 26 low socioeconomic status smokers. Participants were asked to watch eight video-based classes describing mindfulness skills and how to use these skills to overcome various core challenges in tobacco dependence. Participants received eight weekly phone calls from a smoking cessation coach who provided general support and answered questions about the videos. On the quit day, participants received two weeks of nicotine patches.ResultsParticipants were a mean of 40.5 years of age, smoked 16.31 cigarettes per day for 21.88 years, with a mean of 6.81 prior failed quit attempts. Participants completed a mean of 5.55 of 8 online video classes with a mean of 23.33 minutes per login, completed a mean of 3.19 of 8 phone coach calls, and reported a mean meditation practice time of 12.17 minutes per day. Smoking abstinence was defined as self-reported abstinence on a smoking calendar with biochemical confirmation via carbon monoxide breath-test under 7 parts per million. Intent-to-treat analysis demonstrated 7-day point prevalence smoking abstinence at 4 and 6-months post-quit of 23.1% and 15.4% respectively. Participants showed a significant pre- to post-intervention increase in mindfulness as measured by the Five-Factor Mindfulness Questionnaire, and a significant pre- to post-intervention decrease in the Anxiety Sub-scale of the Depression Anxiety and Stress Scale.ConclusionsResults suggest that Mindfulness Training for Smokers can be provided via web-based video instruction with phone support and yield reasonable participant engagement on intervention practices and that intervention efficacy and mechanism of effect deserve further study.Trial registrationClinicalTrials.gov: NCT02164656, Registration Date June 13, 2014.

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Section: Introductionmentioning

confidence: 99%

Mindfulness training for smokers via web-based video instruction with phone support: a prospective observational study

Davis

Manley

Goldberg

et al. 2015

BMC Complement Altern Med

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“…All participants received four counseling sessions. 10,11 The University of Kansas Medical Center Ethics Committee approved all study procedures. More details of the trial have been published previously.…”

Section: Methodsmentioning

confidence: 99%

“…Participants did not receive free smoking cessation medications as part of the randomized trial, 10 so a system to assist them in obtaining medications through their health insurance or a PAP was established. At baseline, study personnel collected information on insurance coverage, income, prescription medication use, and potential contraindications to smoking cessation medications use.…”

Section: Methodsmentioning

confidence: 99%

“…At baseline, study personnel collected information on insurance coverage, income, prescription medication use, and potential contraindications to smoking cessation medications use. 10 If the participant’s insurance program did not cover smoking cessation medications or the patient did not have insurance, counselors provided information on PAPs following the process that is described below.…”

Section: Methodsmentioning

confidence: 99%

“…As part of a clinical trial testing two behavioral intervention approaches to assist smoking cessation in rural Kansas, 10,11 we implemented a protocol to help smokers acquire smoking cessation medications through PAP. In the present report, we detail our approach to helping participants enroll in PAP and the relative success of our efforts in helping participants complete the necessary paperwork and ultimately receive free or reduced-price smoking cessation medications.…”

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confidence: 99%

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Pharmaceutical assistance programs to support smoking cessation medication access

Salas¹,

Hunt²,

Richter³

et al. 2017

Journal of the American Pharmacists Association

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Objectives Rural smokers are more likely to be uninsured and live in poverty, which may pose significant cost barriers to accessing smoking cessation medications. As part of a randomized clinical trial, we provided support to connect low-income smokers with the use of pharmaceutical assistance programs (PAPs) to improve medication access. Methods Study participants were rural smokers enrolled in a randomized clinical trial testing in-office telemedicine versus telephone-based approaches to deliver counseling sessions. For potentially qualified participants, we developed a system to connect them with PAPs that provided smoking cessation medications at low or no cost. Participants reported medication utilization 3 and 6 months after randomization. Results Of the 560 study participants, 312 (55.7%) met initial screening criteria for PAP eligibility. Of those eligible, 104 (33.3%) initiated a PAP application, with 49 (15.7%) completing the application and ultimately receiving medications through the programs. Despite the availability of assistance with the PAP application process, overall medication use among those that were eligible for PAP was significantly lower than among participants with higher incomes or access to prescription insurance (60.4% vs. 51.3%; P = 0.04). Abstinence among PAP-eligible smokers was also lower at the 3-month follow-up (P = 0.01), but this difference was not present at the 6- and 12-month follow-up surveys. Conclusion With substantial assistance, some low-income smokers without prescription insurance can get effective smoking cessation medications through PAPs, but overall access remains worse than among those with higher incomes or prescription insurance.

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Telephone counselling for smoking cessation

Matkin

Ordóñez‐Mena

Hartmann‐Boyce

2019

Cochrane Database of Systematic Reviews

174

155

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Background Telephone services can provide information and support for smokers. Counselling may be provided proactively or o ered reactively to callers to smoking cessation helplines. Objectives To evaluate the e ect of telephone support to help smokers quit, including proactive or reactive counselling, or the provision of other information to smokers calling a helpline. Search methods We searched the Cochrane Tobacco Addiction Group Specialised Register, clinicaltrials.gov, and the ICTRP for studies of telephone counselling, using search terms including 'hotlines' or 'quitline' or 'helpline'. Date of the most recent search: May 2018. Selection criteria Randomised or quasi-randomised controlled trials which o ered proactive or reactive telephone counselling to smokers to assist smoking cessation. Data collection and analysis We used standard methodological procedures expected by Cochrane. We pooled studies using a random-e ects model and assessed statistical heterogeneity amongst subgroups of clinically comparable studies using the I 2 statistic. In trials including smokers who did not call a quitline, we used meta-regression to investigate moderation of the e ect of telephone counselling by the planned number of calls in the intervention, trial selection of participants that were motivated to quit, and the baseline support provided together with telephone counselling (either self-help only, brief face-to-face intervention, pharmacotherapy, or financial incentives). Main results We identified 104 trials including 111,653 participants that met the inclusion criteria. Participants were mostly adult smokers from the general population, but some studies included teenagers, pregnant women, and people with long-term or mental health conditions. Most trials (58.7%) were at high risk of bias, while 30.8% were at unclear risk, and only 11.5% were at low risk of bias for all domains assessed. Most studies (100/104) assessed proactive telephone counselling, as opposed to reactive forms. Among trials including smokers who contacted helplines (32,484 participants), quit rates were higher for smokers receiving multiple sessions of proactive counselling (risk ratio (RR) 1.38, 95% confidence interval (CI) 1.19 to 1.61; 14 trials, 32,484 participants; I 2 = 72%) Telephone counselling for smoking cessation (Review)

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Design and participant characteristics of a randomized-controlled trial of telemedicine for smoking cessation among rural smokers

Cited by 17 publications

References 30 publications

Mindfulness training for smokers via web-based video instruction with phone support: a prospective observational study

Mindfulness training for smokers via web-based video instruction with phone support: a prospective observational study

Pharmaceutical assistance programs to support smoking cessation medication access

Telephone counselling for smoking cessation

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