Smoking, Lung Cancer
Conditions
Keywords
current smoker, health care provider, primary care doctor
Brief summary
This trial studies how well a centralized care strategy works in improving the quality of smoking cessation and shared decision making among patients who smoke and are considering lung cancer screening. The centralized care strategy is a model where smokers eligible for lung cancer screening are referred to a dedicated tobacco treatment program where they receive both the shared decision-making and initiate smoking cessation counseling prior to their visit with a primary care provider. Utilizing the centralized care model may work better in helping people quit smoking and make informed decisions about lung cancer screening compared to usual care.
Detailed description
PRIMARY OBJECTIVE: I. Test the effectiveness of usual care (primary care providers with training in guideline-based smoking cessation and shared decision making) versus (vs.) centralized care (smoking cessation and shared decision making delivered remotely by trained counselors) on smoking abstinence and the quality of patients' decisions about lung cancer screening. SECONDARY OBJECTIVES: I. Evaluate the reach, acceptability, feasibility, and fidelity of the two smoking cessation and shared decision-making implementation models in meeting the requirements from Centers for Medicare & Medicaid Services (CMS) for the lung cancer screening patient counseling and shared decision making visit. II. Conduct budget impact and cost-effectiveness analyses of the two implementation models for the smoking cessation and shared decision making to inform adoption of the intervention beyond the current study. OUTLINE: Participants are randomized to 1 of 2 groups. GROUP I (CENTRALIZED CARE): Participants receive counseling over the phone to help them quit smoking and learn about lung cancer screening over 15-20 minutes for 6-8 sessions over 8 weeks. Participants may also receive nicotine patches. GROUP II (USUAL CARE): Participants receive counseling on lung cancer screening and smoking cessation from primary care providers at health care visit. After completion of study, participants are followed up at 1, 8, and 12 weeks.
Interventions
DRUGNicotine Patch
Given nicotine patches
OTHERQuality-of-Life Assessment
Ancillary studies
OTHERBest Practice
Receive usual care counseling
OTHERQuestionnaire Administration
Ancillary studies
Receive counseling over the phone
Sponsors
National Cancer Institute (NCI)
Cancer Prevention Research Institute of Texas
M.D. Anderson Cancer Center
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
55 Years to 77 Years
Healthy volunteers
Yes
Inclusion criteria
* PATIENTS: Primary care patients * PATIENTS: Upcoming primary care office visit * PATIENTS: Current smoker * PATIENTS: 30 plus (+) pack-year smoking history * PATIENTS: English-speaking * PROVIDERS: Primary health care providers * PROVIDERS: Provide care to adults
Exclusion criteria
* PATIENTS: History of lung cancer by self-report
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Smoking abstinence Questionnairre | Up to 12 weeks | Participants achieving the primary abstinence endpoint at 12 weeks (higher 7-day point prevalence abstinence rates) |
| Lung Cancer Screening 12 items version | Up to 12 weeks | Knowledge of lung cancer screening and benefits of smoking cessation |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Fidelity checklist (11 items) | Up to 12 weeks | Assessment of the feasibility of implementing the intervention |
| Number of patients who received smoking cessation counseling and shared decision making over the number of patients consented to participate in the study | Up to 12 weeks | Assessment of the reach of the intervention |
| Costs of implementing any smoking cessation plus shared decision making intervention | Up to 12 weeks | Costs of personnel, hardware, and delivering materials to participants |
| EuroQoL-5 dimensions | Up to 12 weeks | Standardized measure of health-related quality of life used to generate patient utilities (will report lower decisional conflict, greater decision preparation, greater intention to stop smoking, and be more likely to make an attempt to stop smoking.) |
| Acceptability, appropriateness, and feasibility of the intervention measure (Weiner et al). | Up to 12 weeks | Assessment of the feasibility of implementing the intervention |
Countries
United States
Outcome results
None listed