Behaviorally Enhanced Counseling on Nicotine Dependence (BEACON) Trial.

NCT ID: NCT00991081

Last Updated: 2012-09-19

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

36 participants

Study Classification

INTERVENTIONAL

Study Start Date

2009-07-31

Study Completion Date

2011-03-31

Brief Summary

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The major purpose of this exploratory developmental study will be to develop a patient-centered and feasible protocol for communicating genetic data as it relates to drug efficacy for smoking cessation inpatients receiving medication that is matched to individual genotypes associated with increased efficacy for bupropion or nicotine replacement therapy.

Detailed Description

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Therefore, our specific aims are to:

Aim 1: Conduct formative research to develop and refine a clinical protocol for a multi-component smoking cessation intervention, grounded in the extended parallel process model, consisting of pharmacogenetic treatment (smoking cessation drug matched to each individual smoker's genotype) and genetic feedback (delivery of patient-centered, personalized genotype information and its predictive value for smoking cessation treatment efficacy): We will adapt, pilot-test, and refine a theoretically-grounded PGx smoking cessation intervention using formative interviews of 20 African-American and European-ancestry smokers.

Aim 2: Conduct a mixed-methods feasibility trial randomizing treatment-seeking smokers to pharmacogenetic (PGx) treatment combined with genetic feedback (GF) vs. PGx treatment without GF for smoking cessation to examine the feasibility of the newly developed protocol in a primary care setting and characterize its psychological and behavioral impact: Smokers (N = 100) will be randomized to GF vs. no GF and all will receive motivational interviewing (standard care/SC) and PGx treatment. We will assess the impact of GF on time to relapse, medication adherence, and a comprehensive assessment battery of process and cognitive, psychological, and behavioral outcomes. Finally, we will synthesize quantitative and qualitative data to revise protocols, generate hypothesizes, and estimate effect sizes for a follow-up R01 submission.

Conditions

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Smoking

Keywords

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pharmacogenetics genetic counseling genetic feedback nicotine replacement bupropion smoking cessation primary care telehealth motivational interviewing

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Standard treatment

* Three 20-minute telephone calls during which a certified tobacco treatment specialist delivered motivationally-enhanced cognitive behavioral counseling.
* A self-help guide for smoking cessation (Clearing the Air, NCI)sent by mail
* A standard 8-week course of genetically-tailored pharmacotherapy

* Participants with the A1 allele (TT/CT) were assigned to receive NRT (the Patch)
* Participants with the A2 allele (CC) were assigned to receive bupropion

Group Type ACTIVE_COMPARATOR

Counseling

Intervention Type BEHAVIORAL

Three 20-minute telephone calls during which a certified tobacco treatment specialist delivered motivationally-enhanced cognitive behavioral counseling

1. One week prior to the target quit date (TQD)
2. Two weeks post-TQD
3. Four weeks post-TQD

Self-help guide

Intervention Type BEHAVIORAL

A printed self-help guide for smoking cessation (Clearing the Air, NCI)sent by mail

Pharmacotherapy

Intervention Type DRUG

8-week course of genetically-tailored pharmacotherapy

* Participants with the A1 allele (TT/CT) were assigned to receive NRT (the Patch)
* Participants with the A2 allele (CC) were assigned to receive bupropion

Genetic feedback plus standard treatment

In addition to the standard treatment, participants in this arm received the following interventions:

* Genetic feedback, verbal - During the first counseling call, GF participants were informed of their genotype and provided with the rationale for their pharmacotherapy assignment
* Genetic feedback, printed - After the first counseling call, GF participants were mailed a Personal Treatment Profile, which echoed each participant's ANNK1 genotype, the implications of this for smoking cessation treatment outcome, and which medication was chosen for them based on their genotype

Group Type EXPERIMENTAL

Counseling

Intervention Type BEHAVIORAL

Three 20-minute telephone calls during which a certified tobacco treatment specialist delivered motivationally-enhanced cognitive behavioral counseling

1. One week prior to the target quit date (TQD)
2. Two weeks post-TQD
3. Four weeks post-TQD

Self-help guide

Intervention Type BEHAVIORAL

A printed self-help guide for smoking cessation (Clearing the Air, NCI)sent by mail

Pharmacotherapy

Intervention Type DRUG

8-week course of genetically-tailored pharmacotherapy

* Participants with the A1 allele (TT/CT) were assigned to receive NRT (the Patch)
* Participants with the A2 allele (CC) were assigned to receive bupropion

Genetic feedback, verbal

Intervention Type BEHAVIORAL

During the first counseling call, GF participants were informed of their genotype and provided with the rationale for their pharmacotherapy assignment

Genetic feedback, printed

Intervention Type BEHAVIORAL

After the first counseling call, GF participants were mailed a Personal Treatment Profile, which echoed each participant's ANNK1 genotype, the implications of this for smoking cessation treatment outcome, and which medication was chosen for them based on their genotype.

Interventions

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Counseling

Three 20-minute telephone calls during which a certified tobacco treatment specialist delivered motivationally-enhanced cognitive behavioral counseling

1. One week prior to the target quit date (TQD)
2. Two weeks post-TQD
3. Four weeks post-TQD

Intervention Type BEHAVIORAL

Self-help guide

A printed self-help guide for smoking cessation (Clearing the Air, NCI)sent by mail

Intervention Type BEHAVIORAL

Pharmacotherapy

8-week course of genetically-tailored pharmacotherapy

* Participants with the A1 allele (TT/CT) were assigned to receive NRT (the Patch)
* Participants with the A2 allele (CC) were assigned to receive bupropion

Intervention Type DRUG

Genetic feedback, verbal

During the first counseling call, GF participants were informed of their genotype and provided with the rationale for their pharmacotherapy assignment

Intervention Type BEHAVIORAL

Genetic feedback, printed

After the first counseling call, GF participants were mailed a Personal Treatment Profile, which echoed each participant's ANNK1 genotype, the implications of this for smoking cessation treatment outcome, and which medication was chosen for them based on their genotype.

Intervention Type BEHAVIORAL

Other Intervention Names

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Motivational interviewing Motivational enhancement Support Materials Clearing the Air NRT Nicotine Replacement Therapy The Patch Bupropion Zyban Aplenzin Wellbutrin Pharmacogenetics Pharmacogenetic counseling Pharmacogenetics Pharmacogenetic Feedback

Eligibility Criteria

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Inclusion Criteria

* Adults (aged 18 or older)
* Currently smoke at least 10 cigarettes per day
* Motivated to quit smoking (\>=5 on a 10-point Likert scale)
* Have a telephone
* Read and speak English.

Exclusion Criteria

* Any medical contraindications for transdermal nicotine replacement therapy (NRT) or sustained-release bupropion hydrochloride (bupropion) use based on the package labels (e.g., for bupropion, risk of seizure)
* DSM-IV Axis I diagnosis (other than nicotine dependence)
* Subjects who meet criteria for current major depression, or who demonstrate evidence of suicidal ideation at screening will be referred to treatment for depression and will be excluded from the study
* Must agree not to seek other treatment for smoking cessation during the study.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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SRI International

INDUSTRY

Sponsor Role collaborator

Johns Hopkins University

OTHER

Sponsor Role collaborator

University of Bristol

OTHER

Sponsor Role collaborator

National Institute on Drug Abuse (NIDA)

NIH

Sponsor Role collaborator

Stanford University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Sean P David, MD SM DPhil

Role: PRINCIPAL_INVESTIGATOR

Stanford University

Locations

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SRI International

Menlo Park, California, United States

Site Status

Stanford University School of Medicine

Stanford, California, United States

Site Status

Group Health Research Institute

Seattle, Washington, United States

Site Status

Countries

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United States

References

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McClure JB, Swan GE, St John J, Fauver R, Javitz HS, Bergen AW, Nishita D, Niaura R, Munafo MR, David SP. Pharmacogenetic smoking cessation intervention in a health care setting: a pilot feasibility study. Nicotine Tob Res. 2013 Feb;15(2):518-26. doi: 10.1093/ntr/nts173. Epub 2012 Sep 4.

Reference Type RESULT
PMID: 22949583 (View on PubMed)

Other Identifiers

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5R21DA027331-03

Identifier Type: NIH

Identifier Source: secondary_id

View Link

Protocol # 16513

Identifier Type: OTHER

Identifier Source: secondary_id

SU-09152009-3940

Identifier Type: -

Identifier Source: org_study_id