Patterns of lapses and recoveries during a quit attempt using varenicline and behavioral counseling among smokers with and without HIV.

Ashare, Rebecca L.; Wileyto, E. Paul; Logue-Chamberlain, Erin; Gross, Robert; Tyndale, Rachel F.; Lerman, Caryn; Hawk, Larry W.; Cinciripini, Paul M.; George, Tony P.; Lubitz, Su Fen; Schnoll, Robert A.

doi:10.1037/adb0000619

Cited by 5 publications

(3 citation statements)

References 64 publications

(84 reference statements)

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“…[64,65] Similarly, Ashare and colleagues completed a trial of varenicline compared to placebo in PWH and noted that varenicline was superior to placebo at the close of treatment (PPA: 28.1% vs. 12.1%; Δ = 16.0%). [26] Further, dual NRT (long term patch + ad lib NRT) was similarly efficacious for abstinence at 6 months post quit as varenicline [dual NRT: abstinent = 36.5% (95% Confidence Interval [CI] = 28-45) and varenicline abstinent = 33.2% [29][30][31][32][33][34][35][36][37][38]]. [13] Sample size will be based on a conservative estimate of the effect sizes provided above (Δ = 17%).…”

Section: Power and Sample Sizementioning

confidence: 99%

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Optimizing tobacco treatment delivery for people with HIV: trial protocol for a randomized controlled trial

Sanford

Toll

Eckard

et al. 2022

Addict Sci Clin Pract

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Background With advances in antiretroviral therapy, people with HIV (PWH) are living longer and are less likely to die from AIDS-related complications. Yet, prior research has shown that smoking is often not addressed in the context of HIV care, and few individuals are offered cessation treatment. Optimizing tobacco treatment delivery for PWH may increase engagement with evidence-based treatments and successful quit attempts. Methods The current study is a type 1 hybrid effectiveness-implementation trial to evaluate the impact of a proactive, opt-out tobacco treatment intervention on cessation outcomes and advance understanding of key barriers and facilitators of implementation processes. A total of 230 PWH who smoke will be recruited from an infectious diseases clinic at an academic medical center and will be randomized to receive (1) treatment as usual (TAU) or (2) Proactive Outreach with Medication Opt-out for Tobacco Treatment Engagement (PrOMOTE). Primary outcomes include: biochemically verified 7-day point prevalence abstinence (PPA) rates, continuous abstinence (Weeks 9–12), and the number of 24-hour quit attempts at the end of study treatment (Week 12). Secondary outcomes include: participant reach (proportion reached out of contact attempts), implementation fidelity (including number of prescriptions written), participant adherence to prescribed pharmacotherapy, acceptability (participant and provider satisfaction with intervention delivery and content), and perceived barriers. Discussion This study will examine a novel approach to optimizing tobacco treatment delivery for PWH. Integrating effectiveness and implementation results will help define best practices for engaging PWH with evidence-based tobacco treatment interventions. The intervention is low-cost, has the potential to be highly scalable, and could be translatable to other ambulatory HIV clinic settings. Trial Registration ClinicalTrials.gov: NCT05019495 (August 24, 2021).

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Section: Power and Sample Sizementioning

confidence: 99%

“…[26,27] Optimizing varenicline reach and clinical follow-up to improve adherence may help curb lapses/relapses and improve efficacy. [28][29][30].…”

Section: Introductionmentioning

confidence: 99%

Optimizing tobacco treatment delivery for people with HIV: trial protocol for a randomized controlled trial

Sanford

Toll

Eckard

et al. 2022

Addict Sci Clin Pract

View full text Add to dashboard Cite

show abstract

“…Among PWH, tobacco use rates are 40-50% [4], nearly triple the 15.2% rate of combustible tobacco product use in the general U.S. population [5]. Prior research has shown that approximately 50% of PWH are interested in quitting and 89% have made a quit attempt once in their lifetime [6] but have difficulty achieving abstinence [7]. PWH who continue to smoke after their diagnosis are approximately 20% more likely to die from lung cancer than their societal counterparts [3].…”

Section: Introductionmentioning

confidence: 99%

Optimizing the Implementation of Tobacco Treatment for People with HIV: A Pilot Study

Foster

Toll

Ware

et al. 2022

IJERPH

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People with HIV (PWH) have higher rates of tobacco use compared to their societal counterparts and are disproportionately affected by tobacco-related morbidity and mortality. A needs assessment was conducted to assess provider beliefs and opinions on tobacco treatment barriers and treatment approaches. The results highlighted a disconnect between the known importance of quitting smoking and barriers in linking patients to treatment, such as lack of patient interest and other patient issues being a higher priority. Using this assessment data, a treatment delivery approach, Proactive Outreach with Medication Opt-out for Tobacco Treatment Engagement (PrOMOTE), was devised and piloted. PrOMOTE consisted of an outpatient clinical pharmacist trained in tobacco treatment proactively contacting patients for counseling and to prescribe smoking cessation pharmacotherapy (varenicline or dual nicotine replacement therapy (NRT)) using an opt-out approach. The pilot was conducted with 10 PWH and patient reach and opt-out rates were evaluated. Of the 10 patients contacted, 7 were reached and none opted out of the pharmacotherapy prescription (varenicline = 6; NRT = 1). Providers know the importance of smoking cessation for PWH but encounter several barriers to implementing treatment. Using PrOMOTE methods to deliver tobacco treatment increased the reach and pharmacotherapy acceptance rate of PWH who smoke.

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Nicotine receptor partial agonists for smoking cessation

Livingstone‐Banks

Fanshawe

Thomas

et al. 2023

Cochrane Database of Systematic Reviews

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Background Nicotine receptor partial agonists may help people to stop smoking by a combination of maintaining moderate levels of dopamine to counteract withdrawal symptoms (acting as an agonist) and reducing smoking satisfaction (acting as an antagonist). This is an update of a Cochrane Review first published in 2007. Objectives To assess the effectiveness of nicotine receptor partial agonists, including varenicline and cytisine, for smoking cessation. Search methods We searched the Cochrane Tobacco Addiction Group's Specialised Register in April 2022 for trials, using relevant terms in the title or abstract, or as keywords. The register is compiled from searches of CENTRAL, MEDLINE, Embase, and PsycINFO. Selection criteria We included randomised controlled trials that compared the treatment drug with placebo, another smoking cessation drug, e‐cigarettes, or no medication. We excluded trials that did not report a minimum follow‐up period of six months from baseline. Data collection and analysis We followed standard Cochrane methods. Our main outcome was abstinence from smoking at longest follow‐up using the most rigorous definition of abstinence, preferring biochemically validated rates where reported. We pooled risk ratios (RRs), using the Mantel‐Haenszel fixed‐effect model. We also reported the number of people reporting serious adverse events (SAEs). Main results We included 75 trials of 45,049 people; 45 were new for this update. We rated 22 at low risk of bias, 18 at high risk, and 35 at unclear risk. We found moderate‐certainty evidence (limited by heterogeneity) that cytisine helps more people to quit smoking than placebo (RR 1.30, 95% confidence interval (CI) 1.15 to 1.47; I 2 = 83%; 4 studies, 4623 participants), and no evidence of a difference in the number reporting SAEs (RR 1.04, 95% CI 0.78 to 1.37; I 2 = 0%; 3 studies, 3781 participants; low‐certainty evidence). SAE evidence was limited by imprecision. We found no data on neuropsychiatric or cardiac SAEs. We found high‐certainty evidence that varenicline helps more people to quit than placebo (RR 2.32, 95% CI 2.15 to 2.51; I 2 = 60%, 41 studies, 17,395 participants), and moderate‐certainty evidence that people taking varenicline are more likely to report SAEs than those not taking it (RR 1.23, 95% CI 1.01 to 1.48; I 2 = 0%; 26 studies, 14,356 participants). While point estimates suggested increased risk of cardiac SAEs (RR 1.20, 95% CI 0.79 to 1.84; I 2 = 0%; 18 studies, 7151 participants; low‐certainty evidence), and decreased risk of neuropsychiatric SAEs (RR 0.89, 95% CI 0.61 to 1.29; I 2 = 0%; 22 studies, 7846 participants; low‐certainty evidence), in both cases evidence was limited ...

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Patterns of lapses and recoveries during a quit attempt using varenicline and behavioral counseling among smokers with and without HIV.

Cited by 5 publications

References 64 publications

Optimizing tobacco treatment delivery for people with HIV: trial protocol for a randomized controlled trial

Optimizing tobacco treatment delivery for people with HIV: trial protocol for a randomized controlled trial

Optimizing the Implementation of Tobacco Treatment for People with HIV: A Pilot Study

Nicotine receptor partial agonists for smoking cessation

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