Evaluation of the Ottawa Model for Smoking Cessation in Diabetes Education Programs

NCT ID: NCT01980017

Last Updated: 2022-04-20

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

313 participants

Study Classification

INTERVENTIONAL

Study Start Date

2013-07-31

Study Completion Date

2017-03-15

Brief Summary

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The incidence of type 2 diabetes mellitus (T2DM) is increasing rapidly. The combination of T2DM and smoking is particularly lethal, as smokers with T2DM are significantly more likely to develop a number of health related complications. Community-based diabetes education programs (DEPs) have been developed to support patient self-care behaviours (e.g. adherence to oral medications, insulin therapy, nutrition management, regular blood glucose monitoring, and physical activity); however, specific assistance for smoking cessation is rarely provided. Our investigative team has developed a knowledge transfer and practice change process to introduce evidence-based interventions for smoking cessation into clinical practice settings. This process is known as the Ottawa Model for Smoking Cessation (OMSC). Investigators believe there is an opportunity to use the OMSC intervention to dramatically enhance the effectiveness of DEPs in addressing smoking cessation among smokers with T2DM, and in so doing, improve quit rates in this high risk population.

The purpose of this project is to evaluate the effectiveness of the Ottawa Model for Smoking Cessation (OMSC) intervention in multiple diabetes education programs (DEPs) in Ontario. A two-level recruitment strategy will be employed. Eighteen DEPs will be recruited, and then a consecutive sample of eligible smoker-patients will be recruited from each DEP over a 6-month recruitment period. Investigators want to test the impact of the OMSC intervention on quit rates among smokers with diabetes and pre-diabetes referred to these programs. Investigators will conduct a matched-pair cluster design trial at 18 DEPs in Ontario. These sites will be matched based on number of annual referrals for diabetes education (≤ 500/year or \> 500/year). Within each pair, sites will be allocated randomly to either OMSC intervention or control group. Following randomization, the OMSC program will be implemented at the intervention sites over a 6-month period. Following the implementation period, a consecutive sample of smokers will be recruited from both OMSC intervention and control DEPs over a 6-month recruitment period. It is estimated that this will yield a sample of approximately 445 smokers in each of the OMSC intervention and control groups. The primary outcome will be the biochemically-validated 7-day point prevalence abstinence rate six months after an index visit to the DEP. Secondary outcomes will include: rates of identification and intervention of smokers, and diabetes educators' attitudes, confidence, and perceptions of barriers and facilitators to implementing smoking cessation support as part of routine care.

If proven effective, the OMSC is appropriate for implementation in DEPs across Canada and could have profound impacts on patient and community health.

Detailed Description

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Conditions

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Pre-diabetic Diabetic Type II Mellitus

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

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Wait-Listed Control Group

Usual care for smoking cessation

Group Type NO_INTERVENTION

No interventions assigned to this group

Ottawa Model for Smoking Cessation

Ottawa Model for Smoking Cessation

Group Type EXPERIMENTAL

Ottawa Model for Smoking Cessation

Intervention Type BEHAVIORAL

Interventions

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Ottawa Model for Smoking Cessation

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* The patient has been referred to DEP for T2DM diabetes or pre-diabetes.
* The patient is a current smoker (self-report of daily smoking a minimum of 1 cigarette per day in the 30 days preceding recruitment).
* The patient is aged between 18 years and 80 years.

Exclusion Criteria

* The patient is currently involved in any other smoking cessation intervention.
* The patient is able to read and understand French or English.
* The patient is able to and willing to provide informed consent.
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Ottawa Heart Institute Research Corporation

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Robert Reid, PhD., MBA

Role: PRINCIPAL_INVESTIGATOR

Ottawa Heart Institute Research Corporation

Andrew Pipe, MD, FRCPC

Role: STUDY_CHAIR

Ottawa Heart Institute Research Corporation

Oh Paul, MD, FRCPC

Role: STUDY_CHAIR

Toronto Rehabilitation Institute

Anil Gupta, MD, FRCPC

Role: STUDY_CHAIR

Trillium Heath Centre

Kocourek Jana, MA

Role: STUDY_CHAIR

Ottawa Heart Institute Research Corporation

Mullen Kerri-Anne, MSc.

Role: STUDY_CHAIR

Ottawa Heart Institute Research Corporation

Aiken Debbie, BScN

Role: STUDY_CHAIR

Ottawa Heart Institute Research Corporation

Tulloch Heather, Ph.D., Psych.

Role: STUDY_CHAIR

Ottawa Heart Institute Research Corporation

David Arbeau, BA, BTech, RT

Role: STUDY_CHAIR

Horizon Health Network

Malcolm Janine, MD, FRCPC

Role: STUDY_CHAIR

Faculty of Medicine, University of Ottawa

Locations

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University of Ottawa Heart Institute

Ottawa, Ontario, Canada

Site Status

Countries

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Canada

References

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Willi C, Bodenmann P, Ghali WA, Faris PD, Cornuz J. Active smoking and the risk of type 2 diabetes: a systematic review and meta-analysis. JAMA. 2007 Dec 12;298(22):2654-64. doi: 10.1001/jama.298.22.2654.

Reference Type BACKGROUND
PMID: 18073361 (View on PubMed)

Doll R, Peto R, Boreham J, Sutherland I. Mortality in relation to smoking: 50 years' observations on male British doctors. BMJ. 2004 Jun 26;328(7455):1519. doi: 10.1136/bmj.38142.554479.AE. Epub 2004 Jun 22.

Reference Type BACKGROUND
PMID: 15213107 (View on PubMed)

Stamler J, Vaccaro O, Neaton JD, Wentworth D. Diabetes, other risk factors, and 12-yr cardiovascular mortality for men screened in the Multiple Risk Factor Intervention Trial. Diabetes Care. 1993 Feb;16(2):434-44. doi: 10.2337/diacare.16.2.434.

Reference Type BACKGROUND
PMID: 8432214 (View on PubMed)

Grimshaw JM, Eccles MP, Lavis JN, Hill SJ, Squires JE. Knowledge translation of research findings. Implement Sci. 2012 May 31;7:50. doi: 10.1186/1748-5908-7-50.

Reference Type BACKGROUND
PMID: 22651257 (View on PubMed)

Reid RD, Pipe AL, Quinlan B. Promoting smoking cessation during hospitalization for coronary artery disease. Can J Cardiol. 2006 Jul;22(9):775-80. doi: 10.1016/s0828-282x(06)70294-x.

Reference Type BACKGROUND
PMID: 16835672 (View on PubMed)

Reid RD, Pipe AL, Quinlan B, Oda J. Interactive voice response telephony to promote smoking cessation in patients with heart disease: a pilot study. Patient Educ Couns. 2007 Jun;66(3):319-26. doi: 10.1016/j.pec.2007.01.005. Epub 2007 Mar 1.

Reference Type BACKGROUND
PMID: 17336026 (View on PubMed)

Reid RD, Mullen KA, Slovinec D'Angelo ME, Aitken DA, Papadakis S, Haley PM, McLaughlin CA, Pipe AL. Smoking cessation for hospitalized smokers: an evaluation of the "Ottawa Model". Nicotine Tob Res. 2010 Jan;12(1):11-8. doi: 10.1093/ntr/ntp165. Epub 2009 Nov 10.

Reference Type BACKGROUND
PMID: 19903737 (View on PubMed)

Reid RD, Mullen KA, Pipe AL. Systematic approaches to smoking cessation in the cardiac setting. Curr Opin Cardiol. 2011 Sep;26(5):443-8. doi: 10.1097/HCO.0b013e3283497499.

Reference Type BACKGROUND
PMID: 21730824 (View on PubMed)

SRNT Subcommittee on Biochemical Verification. Biochemical verification of tobacco use and cessation. Nicotine Tob Res. 2002 May;4(2):149-59. doi: 10.1080/14622200210123581. No abstract available.

Reference Type BACKGROUND
PMID: 12028847 (View on PubMed)

Donner A, Donald A. Analysis of data arising from a stratified design with the cluster as unit of randomization. Stat Med. 1987 Jan-Feb;6(1):43-52. doi: 10.1002/sim.4780060106.

Reference Type BACKGROUND
PMID: 3576016 (View on PubMed)

Thompson SG, Pyke SD, Hardy RJ. The design and analysis of paired cluster randomized trials: an application of meta-analysis techniques. Stat Med. 1997 Sep 30;16(18):2063-79. doi: 10.1002/(sici)1097-0258(19970930)16:183.0.co;2-8.

Reference Type BACKGROUND
PMID: 9308132 (View on PubMed)

Campbell MK, Mollison J, Grimshaw JM. Cluster trials in implementation research: estimation of intracluster correlation coefficients and sample size. Stat Med. 2001 Feb 15;20(3):391-9. doi: 10.1002/1097-0258(20010215)20:33.0.co;2-z.

Reference Type BACKGROUND
PMID: 11180309 (View on PubMed)

Papadakis S, Aitken D, Gocan S, Riley D, Laplante MA, Bhatnagar-Bost A, Cousineau D, Simpson D, Edjoc R, Pipe AL, Sharma M, Reid RD. A randomised controlled pilot study of standardised counselling and cost-free pharmacotherapy for smoking cessation among stroke and TIA patients. BMJ Open. 2011 Nov 28;1(2):e000366. doi: 10.1136/bmjopen-2011-000366. Print 2011.

Reference Type BACKGROUND
PMID: 22123923 (View on PubMed)

Reid RD, Pipe A, Dafoe WA. Is telephone counselling a useful addition to physician advice and nicotine replacement therapy in helping patients to stop smoking? A randomized controlled trial. CMAJ. 1999 Jun 1;160(11):1577-81.

Reference Type BACKGROUND
PMID: 10373999 (View on PubMed)

Reid RD, Pipe AL. A telephone-based support program for over-the-counter nicotine patch users. Can J Public Health. 1999 Nov-Dec;90(6):397-8. doi: 10.1007/BF03404144. No abstract available.

Reference Type BACKGROUND
PMID: 10680265 (View on PubMed)

Slovinec D'Angelo ME, Reid RD, Hotz S, Irvine J, Segal RJ, Blanchard CM, Pipe A. Is stress management training a useful addition to physician advice and nicotine replacement therapy during smoking cessation in women? Results of a randomized trial. Am J Health Promot. 2005 Nov-Dec;20(2):127-34. doi: 10.4278/0890-1171-20.2.127.

Reference Type BACKGROUND
PMID: 16295704 (View on PubMed)

Rigotti NA, Pipe AL, Benowitz NL, Arteaga C, Garza D, Tonstad S. Efficacy and safety of varenicline for smoking cessation in patients with cardiovascular disease: a randomized trial. Circulation. 2010 Jan 19;121(2):221-9. doi: 10.1161/CIRCULATIONAHA.109.869008. Epub 2010 Jan 4.

Reference Type BACKGROUND
PMID: 20048210 (View on PubMed)

Campbell MK, Piaggio G, Elbourne DR, Altman DG; CONSORT Group. Consort 2010 statement: extension to cluster randomised trials. BMJ. 2012 Sep 4;345:e5661. doi: 10.1136/bmj.e5661. No abstract available.

Reference Type BACKGROUND
PMID: 22951546 (View on PubMed)

Reid RD, Malcolm J, Wooding E, Geertsma A, Aitken D, Arbeau D, Blanchard C, Gagnier JA, Gupta A, Mullen KA, Oh P, Papadakis S, Tulloch H, LeBlanc AG, Wells GA, Pipe AL. Prospective, Cluster-Randomized Trial to Implement the Ottawa Model for Smoking Cessation in Diabetes Education Programs in Ontario, Canada. Diabetes Care. 2018 Mar;41(3):406-412. doi: 10.2337/dc17-1809. Epub 2017 Dec 21.

Reference Type DERIVED
PMID: 29269509 (View on PubMed)

Other Identifiers

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20130177-01H

Identifier Type: -

Identifier Source: org_study_id

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