Telephone care co-ordination for tobacco cessation: Randomised trials testing proactive versus reactive models

Scott Sherman, Paul Krebs, Laura S. York, Sharon E. Cummins, Ware Kuschner, Sebnem Guvenc-Tuncturk, Shu Hong Zhu

Research output: Contribution to journalArticle

Abstract

Objectives We conducted two parallel studies evaluating the effectiveness of proactive and reactive engagement approaches to telephone treatment for smoking cessation. Methods Patients who smoked and were interested in quitting were referred to this study and were eligible if they were current smokers and had an address and a telephone number. The data were collected at 35 Department of Veterans Affairs (VA) sites, part of four VA medical centres in both California and Nevada. In study 1, participants received multisession counselling from the California Smokers’ Helpline (quitline). In study 2, they received self-help materials only. Patients were randomly assigned by week to either proactive or reactive engagement, and primary care staff were blind to this assignment. Providers gave brief advice and referred them via the electronic health record to a tobacco co-ordinator. All patients were offered cessation medications. Outcome Using complete case analysis, in study 1 (quitline), patients in the proactive condition were more likely than those in the reactive condition to report abstinence at 6 months (21.0% vs 16.4%, p=0.03). No difference was found between conditions in study 2 (self-help) (16.9% vs 16.5%, p=0.88). Proactive outreach resulted in increased use of cessation medications in both the quitline (70.1% vs 57.6%, p<0.0001) and the self-help studies (74.5% vs 48.2%, p<0.0001). conclusion Proactive outreach with quitline intervention was associated with greater long-term abstinence. Both studies resulted in high rates of medication use. Sites should use a proactive outreach approach and provide counselling whenever possible.

Original languageEnglish (US)
Pages (from-to)78-82
Number of pages5
JournalTobacco Control
Volume27
Issue number1
DOIs
StatePublished - Jan 1 2018

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Tobacco Use Cessation
self-help
Telephone
nicotine
telephone
medication
counseling
Veterans
Counseling
smoking
Electronic Health Records
Smoking Cessation
electronics
Tobacco
staff
Primary Health Care
health

ASJC Scopus subject areas

  • Health(social science)
  • Public Health, Environmental and Occupational Health

Cite this

Telephone care co-ordination for tobacco cessation : Randomised trials testing proactive versus reactive models. / Sherman, Scott; Krebs, Paul; York, Laura S.; Cummins, Sharon E.; Kuschner, Ware; Guvenc-Tuncturk, Sebnem; Zhu, Shu Hong.

In: Tobacco Control, Vol. 27, No. 1, 01.01.2018, p. 78-82.

Research output: Contribution to journalArticle

Sherman, Scott ; Krebs, Paul ; York, Laura S. ; Cummins, Sharon E. ; Kuschner, Ware ; Guvenc-Tuncturk, Sebnem ; Zhu, Shu Hong. / Telephone care co-ordination for tobacco cessation : Randomised trials testing proactive versus reactive models. In: Tobacco Control. 2018 ; Vol. 27, No. 1. pp. 78-82.
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abstract = "Objectives We conducted two parallel studies evaluating the effectiveness of proactive and reactive engagement approaches to telephone treatment for smoking cessation. Methods Patients who smoked and were interested in quitting were referred to this study and were eligible if they were current smokers and had an address and a telephone number. The data were collected at 35 Department of Veterans Affairs (VA) sites, part of four VA medical centres in both California and Nevada. In study 1, participants received multisession counselling from the California Smokers’ Helpline (quitline). In study 2, they received self-help materials only. Patients were randomly assigned by week to either proactive or reactive engagement, and primary care staff were blind to this assignment. Providers gave brief advice and referred them via the electronic health record to a tobacco co-ordinator. All patients were offered cessation medications. Outcome Using complete case analysis, in study 1 (quitline), patients in the proactive condition were more likely than those in the reactive condition to report abstinence at 6 months (21.0{\%} vs 16.4{\%}, p=0.03). No difference was found between conditions in study 2 (self-help) (16.9{\%} vs 16.5{\%}, p=0.88). Proactive outreach resulted in increased use of cessation medications in both the quitline (70.1{\%} vs 57.6{\%}, p<0.0001) and the self-help studies (74.5{\%} vs 48.2{\%}, p<0.0001). conclusion Proactive outreach with quitline intervention was associated with greater long-term abstinence. Both studies resulted in high rates of medication use. Sites should use a proactive outreach approach and provide counselling whenever possible.",
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