Automated telephone follow-up for smoking cessation in smokers with coronary heart disease: a randomized controlled trial

Automated telephone follow-up for smoking cessation in smokers with coronary heart disease: a... Abstract Introduction Smokers with coronary heart disease (CHD) benefit from in-hospital cessation treatment, but relapse is common without ongoing support post-discharge. The purpose of this study was to determine if smoking abstinence would be higher after hospital discharge in smokers who received automated telephone follow-up (ATF) and nurse counseling, compared to a standard care (SC) control group. Methods A total of 440 smokers hospitalized with CHD were randomly assigned to the ATF group (n=216) or to the SC group (n=224). Participants in the ATF group received automated phone calls three, 14, 30, 60, 90, 120, 150 and 180 days after hospital discharge. The ATF system posed questions concerning smoking status, confidence in staying smoke-free, and need for assistance. If flagged by the ATF system, a nurse-counselor provided additional counseling by phone. Self-reported continuous smoking abstinence was assessed 26 and 52 weeks post-discharge using intention-to-treat analysis. The main outcome measure was continuous abstinence for weeks 1-26 post-discharge. Results Participants in the ATF group achieved higher abstinence rates for weeks 1-26 than those in the SC group (odds ratio [OR] 1.53, 95% confidence intervals [CI] 1.01-2.33). There was no significant difference between groups in abstinence rates for weeks 27-52 (OR 1.37; 95% CI 0.89 to 2.09). Conclusions ATF-mediated follow-up helped smokers with CHD achieve abstinence during the intervention period. There was a trend toward clinically important improvements for weeks 27-52; but between group differences for this time point did not achieve statistical significance. Clinical Trial Number: NCT00449852 Implications Automated telephone follow-up exerts its effect by reinforcing participants’ efforts to be smoke-free and by proactively linking people requiring assistance to individualized support (e.g., telephone counseling). This study shows that automated telephone follow-up can assist smokers with coronary heart disease in remaining smoke free; however, success of automated telephone follow-up is limited to the treatment period and abstinence rates after the treatment period were not statistically different than among those receiving standard care. Extended treatment via automated telephone follow-up may provide a solution to extend cessation assistance beyond hospital discharge. © The Author(s) 2018. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com. This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/about_us/legal/notices) http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Nicotine and Tobacco Research Oxford University Press

Automated telephone follow-up for smoking cessation in smokers with coronary heart disease: a randomized controlled trial

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Publisher
Oxford University Press
Copyright
© The Author(s) 2018. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
ISSN
1462-2203
eISSN
1469-994X
D.O.I.
10.1093/ntr/nty108
Publisher site
See Article on Publisher Site

Abstract

Abstract Introduction Smokers with coronary heart disease (CHD) benefit from in-hospital cessation treatment, but relapse is common without ongoing support post-discharge. The purpose of this study was to determine if smoking abstinence would be higher after hospital discharge in smokers who received automated telephone follow-up (ATF) and nurse counseling, compared to a standard care (SC) control group. Methods A total of 440 smokers hospitalized with CHD were randomly assigned to the ATF group (n=216) or to the SC group (n=224). Participants in the ATF group received automated phone calls three, 14, 30, 60, 90, 120, 150 and 180 days after hospital discharge. The ATF system posed questions concerning smoking status, confidence in staying smoke-free, and need for assistance. If flagged by the ATF system, a nurse-counselor provided additional counseling by phone. Self-reported continuous smoking abstinence was assessed 26 and 52 weeks post-discharge using intention-to-treat analysis. The main outcome measure was continuous abstinence for weeks 1-26 post-discharge. Results Participants in the ATF group achieved higher abstinence rates for weeks 1-26 than those in the SC group (odds ratio [OR] 1.53, 95% confidence intervals [CI] 1.01-2.33). There was no significant difference between groups in abstinence rates for weeks 27-52 (OR 1.37; 95% CI 0.89 to 2.09). Conclusions ATF-mediated follow-up helped smokers with CHD achieve abstinence during the intervention period. There was a trend toward clinically important improvements for weeks 27-52; but between group differences for this time point did not achieve statistical significance. Clinical Trial Number: NCT00449852 Implications Automated telephone follow-up exerts its effect by reinforcing participants’ efforts to be smoke-free and by proactively linking people requiring assistance to individualized support (e.g., telephone counseling). This study shows that automated telephone follow-up can assist smokers with coronary heart disease in remaining smoke free; however, success of automated telephone follow-up is limited to the treatment period and abstinence rates after the treatment period were not statistically different than among those receiving standard care. Extended treatment via automated telephone follow-up may provide a solution to extend cessation assistance beyond hospital discharge. © The Author(s) 2018. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com. This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/about_us/legal/notices)

Journal

Nicotine and Tobacco ResearchOxford University Press

Published: May 25, 2018

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