Tobacco Dependence Clinical Trial
Official title:
A POPULATION-BASED DIRECT-TO-SMOKER OUTREACH OFFERING TOBACCO TREATMENT IN A HEALTH CARE SETTING: A RANDOMIZED CONTROLLED TRIAL
Tobacco use is the leading preventable cause of death in the United States. Effective
treatment for tobacco dependence exists and includes counseling and pharmacotherapy with
nicotine replacement, bupropion, or varenicline. The health care system is a key channel for
delivering this treatment to smokers. Brief clinical interventions delivered at office
visits increase smoking cessation rates, are among the most cost-effective of medical
interventions, and are recommended by U.S. Public Health Service. However, physicians and
other clinicians often fail to provide them. Clinicians' rates of providing tobacco
treatment in ambulatory care can be improved, but even when successful, clinicians can only
reach smokers who make an office visit.
A health care system might improve its delivery of tobacco treatment by supplementing
visit-based efforts with a population-based strategy, using methods proven effective in
public health settings. A population of smokers could be identified from electronic health
records and offered treatment proactively in a way that maximizes convenience and minimizes
barriers such the cost of pharmacotherapy. This study tests the effectiveness of a
population-based Direct-to-Smoker (DTS) outreach program provided to smokers in one
community health center in Revere, MA, that is part of an integrated health care system. It
uses the system's population management tools to identify smokers and proactively offers
them evidence-based tobacco treatment that is free and does require making an office visit.
A randomized controlled trial will compare the effectiveness of the DTS program to usual
primary care. The hypothesis is that adding the DTS program to usual primary care will
increase the proportion of smokers who use tobacco dependence treatment and thereby stop
smoking.
n/a
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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