Hospitalized Smokers

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

1054 participants

Study Classification

INTERVENTIONAL

Study Start Date

2011-02-28

Study Completion Date

2016-01-31

Brief Summary

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Post-discharge support is a key component of effective treatment for hospitalized smokers, but very few hospitals provide it. Linking hospitalized smokers with free, proactive tobacco quitlines is an ideal way to provide supportive contact at discharge, because quitlines are effective and cost effective for smoking cessation. Many hospitals are beginning to fax-refer smokers to quitlines at discharge. Fax referral is convenient and is part of the current culture of medical communication channels. However, less than half of fax-referred smokers are successfully contacted and enrolled in quitline services. "Warm hand-off" is a novel approach to care transitions in which health care providers directly link patients that have substance abuse and mental health problems with specialists, using face-to-face or phone transfer. Warm hand-off achieves very high rates of treatment enrollment for these highly vulnerable groups.

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Detailed Description

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The objective if this application is to determine the relative effectiveness, and cost-effectiveness, of warm hand-off versus fax referral for linking hospitalized smokers with tobacco quitlines. This study employs a two-arm, individually randomized design. It is set in two large Kansas hospitals that have dedicated tobacco treatment interventionists on staff.

Conditions

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Hospitalized Smokers

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

NONE

Study Groups

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Fax

Group Type ACTIVE_COMPARATOR

Fax

Intervention Type OTHER

Fax

Staff standard in-patient session: (30 minutes):

* Assess withdrawal, need for medication change
* Conduct assessment of smoking history, interest in quitting
* Explore relevance, risks, rewards, and roadblocks (4Rs) related to smoking and quitting
* Provide 2-page flyer
* Provide medication education
* Build plan to stay quit
* Describe fax-referral process
* Ask if patient requests cessation medication script on discharge

Warm Hand-off

Group Type EXPERIMENTAL

Warm Hand-off

Intervention Type OTHER

Warm Hand-Off

Staff brief intervention and warm hand-off (5 min):

* Assess withdrawal, need for medication change
* Describe warm hand-off process
* Provide 2-page flyer
* Perform call, leave room
* Notify patients' nurse patient is talking to quitline

Quitline session (20 min):

* Collect minimum data set
* Explore thoughts/feelings toward quitting
* Provide medication education
* Build plan to stay quit
* Schedule next call

Staff check-back (5 min):

* Ask patient how session went
* Ask if patient requests cessation medication script on discharge

Interventions

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Warm Hand-off

Warm Hand-Off

Staff brief intervention and warm hand-off (5 min):

* Assess withdrawal, need for medication change
* Describe warm hand-off process
* Provide 2-page flyer
* Perform call, leave room
* Notify patients' nurse patient is talking to quitline

Quitline session (20 min):

* Collect minimum data set
* Explore thoughts/feelings toward quitting
* Provide medication education
* Build plan to stay quit
* Schedule next call

Staff check-back (5 min):

* Ask patient how session went
* Ask if patient requests cessation medication script on discharge

Intervention Type OTHER

Fax

Fax

Staff standard in-patient session: (30 minutes):

* Assess withdrawal, need for medication change
* Conduct assessment of smoking history, interest in quitting
* Explore relevance, risks, rewards, and roadblocks (4Rs) related to smoking and quitting
* Provide 2-page flyer
* Provide medication education
* Build plan to stay quit
* Describe fax-referral process
* Ask if patient requests cessation medication script on discharge

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* aged 18 years and older,
* have smoked at least 1 cigarette in the 30 days prior to admission,
* speak Spanish or English,
* and wish to remain abstinent after they are discharged
* Patients who are discharged to another facility (for long term care or rehabilitation) will be included in the trial.

Exclusion Criteria

* acute life-threatening medical conditions (for example, cardiac arrest, acute respiratory failure, septic shock),
* communication barriers (intubation, unable to speak or hear),
* altered mental status,
* severe unstable psychiatric disorder (acute psychosis),
* terminal illness with less than a 12 month life expectancy
* non-Kansans because residents of other states may receive quitline services from a different vendor which would confound intervention effects and make it difficult to obtain quitline adherence data

Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes