Effectiveness of Combining Feedback about Lung Age or Exhaled Carbon Monoxide Levels with Very Brief Advice (VBA) and Support for Smoking Cessation in Primary Care Compared to Giving VBA and Support Alone – Protocol for a Randomized Controlled Trial withi

Authors

  • Dragan Gjorgjievski Centre for Family Medicine, Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia
  • Radmila Ristovska Centre for Family Medicine, Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia
  • Katarina Stavrikj Centre for Family Medicine, Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia
  • Amanda Farley Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
  • Peymane Adab Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
  • Rachel Adams Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
  • Andy Dickens Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
  • Alexandra Enocson Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
  • Gjorgji Stanoevski Centre for Family Medicine, Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia
  • Nicola Gale Faculty of Medicine, Institute of Social Medicine, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia
  • Sue Jowett Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
  • Kiran Rai Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
  • Alice Sitch Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
  • Aleksandra Stamenova Faculty of Medicine, Institute of Social Medicine, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia
  • Emilija Krstevska Centre for Family Medicine, Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia
  • Rachel Jordan Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom

DOI:

https://doi.org/10.3889/oamjms.2020.4519

Keywords:

very brief advice, lung age, Co levels

Abstract

INTRODUCTION: In 2015, smoking prevalence in Republic of Macedonia was 36% in men and 21% in women We aim to assess the effectiveness and cost-effectiveness of two methods of motivating smokers to quit smoking compared with very brief advice (VBA) alone. Тo date, there are no studies investigating smoking cessation treatment in Republic of Macedonia.

METHODS/DESIGN: RCT with process evaluation and cost-effectiveness analysis within 31 general practices in Republic of Macedonia recruiting smokers currently smoking >10 cigarettes per day, aged >35 years, attending primary care practices for any reason, regardless of motivation to quit smoking. Respondents will be randomized into one of three groups: (1) VBA and assessment and communication of lung age; (2) VBA and additional assessment and communication of exhaled carbon monoxide (CO) levels; or (3) control group – VBA. All participants who attempt to quit smoking will be offered behavioral support based on the UK standard program for smoking cessation. Primary outcome: Proportion of smokers who are quit at 4 weeks (7-day point prevalence, confirmed by salivary cotinine level). Secondary outcomes: Proportion who have attempted to quit smoking or have quit smoking, a proportion that has reduced the number of cigarettes and motivation to quit smoking; cost-effectiveness analysis calculating cost per quality-adjusted life year. We will evaluate the fidelity to the intervention and will explore patients’ and GPs’ experience and the acceptability of the study intervention by interview.

DISCUSSION: The study will evaluate the effectiveness of combining feedback about lung age or exhaled CO levels with VBA and support for smoking cessation in primary care compared to giving VBA and support alone. It will explore how willing primary care physicians are to perform such interventions and the acceptability and effectiveness of such interventions to patients in Republic of Macedonia.

TRIAL REGISTRATION: The study is registered on the ISRCTN registry (ISRCTN54228638).

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References

US Department of Health and Human Services. The Health Consequences of Smoking 50 Years of Progress: A Report of the Surgeon General; 2014. Available from: https://www.surgeongeneral.gov/library/reports/50-years-of-progress/full-report.pdf. [Last accessed on 2018 Apr 04]. https://doi.org/10.1037/e510072014-001

World Health Organization. Tobacco: The Problem. Geneva: World Health Organization; 2009. Available from: http://www.who.int/nmh/publications/fact_sheet_tobacco_en.pdf. [Last accessed on 2018 Apr 04].

US Department of Health and Human Services. The Health Benefits of Smoking Cessation; 1990. Available from: https://www.profiles.nlm.nih.gov/ps/access/NNBBCT.pdf. [Last accessed on 2018 Apr 04]

Gometz AD. Health effects of smoking and the benefits of quitting. J Ethic 2011;13:31-5.

Centers for Disease Control and Prevention. Smoking and Tobacco Use: Quitting Smoking. Atlanta, Georgia: Centers for Disease Control and Prevention; 2017. Available from: https://www.cdc.gov/tobacco/data_statistics/fact_sheets/cessation/quitting/index.htm. [Last accessed on 2018 Apr 04]. https://doi.org/10.18332/tpc/105210

Doll R, Peto R, Boreham J, Sutherland I. Mortality in relation to smoking: 50 years’ observations on male British doctors. Br Med J 2004;328:1519. https://doi.org/10.1136/bmj.38142.554479.ae

The Tobacco Atlas. The Republic of Republic of Macedonia: Issues; 2017. Available from: https://www.tobaccoatlas.org/country/therepublicofrepublicofmacedonia. [Last accessed on 2018 Apr 04].

International Primary Care Respiratory Group (IPCRG) wins Global Bridges Grant to Work in Eastern Europe; 2018. Capacity Building Teaching the Teachers of Primary Healthcare Professionals to Treat Tobacco Dependence Available from: https://www.theipcrg.org/display/TeachColleagues/ Teaching+the+teachers+of+pri

Henry Ford Health System and Saints Cyril and Methodius University, Collaborative Development of a Continuing Education Program to Train Healthcare Providers on Tobacco Cessation Counseling in the Republic of Macedonia; 2016. Available from: https://www.pfe-pfizercom-prod.s3.amazonaws.com/funded_initiative_proposal/25682297%20HENRY%20FORD%20HEALTH%20SYSTEM%20Full%20Proposal.pdf. [Last accessed on 2018 Apr 04].

NCSCT. Standard Treatment Programme. Available from: http://wwwncsctcouk/publication_ncsct-standard-treatment-programmephp. [Last accessed on 2018 Jul 06].

Hartmann-Boyce J, Stead LF, Cahill K, Lancaster T. Efficacy of interventions to combat tobacco addiction: Cochrane update of 2013 reviews. Addiction. 2014;109(9):1414-25. https://doi.org/10.1111/add.12633 PMid:24995905

Stead LF, Buitrago D, Preciado N, Sanchez G, Hartmann-Boyce J, Lancaster T. Physician advice smoking cessation. Cochrane Database Syst Rev. 2013;31(5):CD000165. https://doi.org/10.1002/14651858.cd000165.pub4 PMid:23728631

McBride CM, Emmons KM, Lipkus IM. Understanding the potential of teachable moments: The case of smoking cessation. Health Educ Res. 2003;18(2):156-70. https://doi.org/10.1093/her/18.2.156 PMid:12729175

McClure JB. Are biomarkers a useful aid in smoking cessation? A review and analysis of the literature. Behav Med. 2001;27(1):37-47. PMid:11575171

Bize R, Burnand B, Mueller M, Rege-Walther M, Camain JY, Cornuz J. Biomedical risk assessment as an aid for smoking cessation. Cochrane Database Syst Rev. 2012;12:CD004705. https://doi.org/10.1002/14651858.cd004705.pub4 PMid:23235615

Morris JF, Temple W. Spirometric “lung age†estimation for motivating smoking cessation. Prevent Med. 1985;14(5):655-62. https://doi.org/10.1016/0091-7435(85)90085-4

Lung Foundation Australia. Available from: https://ww.lungfoundation.com.au. [Last accessed on 2018 Apr 04].

Ojedokun J, Keane S, O’Connor K. Lung age bio-feedback using a portable lung age meter with brief advice during routine consultations promotes smoking cessation? Know2quit multicenter randomized control trial. J Gen Pract. 2013;1(123):2. https://doi.org/10.4172/2329-9126.1000123

Papathanasiou G, Mamali A, Papafloratos S, Zerva E. Effects of smoking on cardiovascular function: The role of nicotine and carbon monoxide. Health Sci J. 2014;8(2):274-90.

Shahab L, West R, McNeill A. A randomized, controlled trial of adding expired carbon monoxide feedback to brief stop smoking advice: evaluation of cognitive and behavioral effects. Health Psychol. 2011;30(1):49-57. https://doi.org/10.1037/a0021821 PMid:21299294.

Sanders D, Fowler G, Mant D, Fuller A, Jones J, Marzillier J. Randomized controlled trial of anti-smoking advice by nurses in general practice. J R Coll Gen Pract. 1989;39(324):273-6. PMid:2556540

Jamrozik K, Vessey M, Fowler G, Wald N, Parker G, Vunakins HV. Controlled trial of three different antismoking interventions in general practice. Br Med J. 1984;288(6429):1499-1503. https://doi.org/10.1136/bmj.288.6429.1499 PMid:6426618

Audrain J, Boyd NR, Roth J, Main D, Caporaso NF, Lerman C. Genetic susceptibility in smoking-cessation treatment: One-year outcomes of a randomized trial. Addict Behav. 1997;22(6):741-51. https://doi.org/10.1016/s0306-4603(97)00060-9 PMid:9426791

MRC Guidance. Available from: https://www.bmjopen.bmj.com/content/9/8/e029954. [Last accessed on 2018 Apr 04].

Spirometry Indications and Contraindications. Available from: https://www.news-medical.net/health/Spirometry-Indications-and-Contraindications.aspx.[Last accessed on 2018 Apr 04]

Fagerstrom Test for Nicotine Dependence Available from: http://www.ndri.curtin.edu.au/btitp/documents/Fagerstrom_test.pdf. [Last accessed on 2018 Apr 04].

Kotz DB, West R. Predictive validity of the motivation to stop smoking scale: A single-item measure of motivation to stop smoking. Drug Alcohol Depend. 2013;128(1-2):15-9. https://doi.org/10.1016/j.drugalcdep.2012.07.012 PMid:22943961

Pope C, Ziebland S, Mays N. Qualitative research in health care: Analysing qualitative data. BMJ. 2000;320(7227):114-6. https://doi.org/10.1136/bmj.320.7227.114 PMid:10625273

West R, Hajek P, Stead L, Stapleton J. Outcome criteria in smoking cessation trials: Proposal for a common standard. Addiction. 2005;100(3):299-303. https://doi.org/10.1111/j.1360-0443.2004.00995.x PMid:15733243

EQ-5D-5L Questionnaire. Available from: https://www.euroqol.org/eq -5d- instruments /eq-5d-5l-about. https://doi.org/10.1007/spring erreference _184469. [Last accessed on 2018 Apr 04]

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Published

2020-03-25

How to Cite

1.
Gjorgjievski D, Ristovska R, Stavrikj K, Farley A, Adab P, Adams R, Dickens A, Enocson A, Stanoevski G, Gale N, Jowett S, Rai K, Sitch A, Stamenova A, Krstevska E, Jordan R. Effectiveness of Combining Feedback about Lung Age or Exhaled Carbon Monoxide Levels with Very Brief Advice (VBA) and Support for Smoking Cessation in Primary Care Compared to Giving VBA and Support Alone – Protocol for a Randomized Controlled Trial withi. Open Access Maced J Med Sci [Internet]. 2020 Mar. 25 [cited 2024 Nov. 26];8(E):27-35. Available from: https://oamjms.eu/index.php/mjms/article/view/4519

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