A randomised controlled trial to prevent smoking relapse among recently quit smokers enrolled in employer and health plan sponsored quitlines

Anna M. McDaniel, Katrina A. Vickerman, Timothy E. Stump, Patrick Monahan, Jeffrey L. Fellows, Michael T. Weaver, Beatriz H. Carlini, Victoria Champion, Susan M. Zbikowski

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Objective: To test adding an interactive voice response (IVR)-supported protocol to standard quitline treatment to prevent relapse among recently quit smokers. Design: Parallel randomised controlled trial with three arms: standard quitline, standard plus technology enhanced quitline with 10 risk assessments (TEQ-10), standard plus 20 TEQ assessments (TEQ-20). Setting: Quit For Life (QFL) programme. Participants: 1785 QFL enrolees through 19 employers or health plans who were 24+ h quit. Interventions: QFL is a 5-call telephone-based cessation programme including medications and web-based support. TEQ interventions included 10 or 20 IVR-delivered relapse risk assessments over 8 weeks with automated transfer to counselling for those at risk. Main outcome measures: Self-reported 7-day and 30-day abstinence assessed at 6-month and 12-month post-enrolment (response rates: 61% and 59%, respectively). Missing data were imputed. Results: 1785 were randomised (standard n=592, TEQ-10 n=602, TEQ-20 n=591). Multiple imputation-derived, intent-to-treat 30-day quit rates (95% CI) at 6 months were 59.4% (53.7% to 63.8%) for standard, 62.3% (57.7% to 66.9%) for TEQ-10, 59.4% (53.7% to 65.1%) for TEQ-20 and 30-day quit rates at 12 months were 61.2% (55.6% to 66.8%) for standard, 60.6% (56.0% to 65.2%) for TEQ-10, 54.9% (49.0% to 60.9%) for TEQ-20. There were no significant differences in quit rates. 73.3% of TEQ participants were identified as at-risk by IVR assessments; on average, participants completed 0.41 IVR-transferred counselling calls. Positive risk assessments identified participants less likely (OR=0.56, 95% CI 0.42 to 0.76) to be abstinent at 6 months. Conclusions: Standard treatment was highly effective, with 61% remaining abstinent at 12 months using multiple imputation intent-to-treat (intent-to-treat missing=smoking quit rate: 38%). TEQ assessments identified quitters at risk for relapse. However, adding IVR-transferred counselling did not yield higher quit rates. Research is needed to determine if alternative designs can improve outcomes.

Original languageEnglish (US)
Article numbere007260
JournalBMJ Open
Volume5
Issue number6
DOIs
StatePublished - 2015

Fingerprint

Randomized Controlled Trials
Smoking
Recurrence
Health
Counseling
Telephone
Outcome Assessment (Health Care)
Technology
Research

ASJC Scopus subject areas

  • Medicine(all)

Cite this

A randomised controlled trial to prevent smoking relapse among recently quit smokers enrolled in employer and health plan sponsored quitlines. / McDaniel, Anna M.; Vickerman, Katrina A.; Stump, Timothy E.; Monahan, Patrick; Fellows, Jeffrey L.; Weaver, Michael T.; Carlini, Beatriz H.; Champion, Victoria; Zbikowski, Susan M.

In: BMJ Open, Vol. 5, No. 6, e007260, 2015.

Research output: Contribution to journalArticle

McDaniel, Anna M. ; Vickerman, Katrina A. ; Stump, Timothy E. ; Monahan, Patrick ; Fellows, Jeffrey L. ; Weaver, Michael T. ; Carlini, Beatriz H. ; Champion, Victoria ; Zbikowski, Susan M. / A randomised controlled trial to prevent smoking relapse among recently quit smokers enrolled in employer and health plan sponsored quitlines. In: BMJ Open. 2015 ; Vol. 5, No. 6.
@article{de46055f74b441e0bdc26c27586c9c33,
title = "A randomised controlled trial to prevent smoking relapse among recently quit smokers enrolled in employer and health plan sponsored quitlines",
abstract = "Objective: To test adding an interactive voice response (IVR)-supported protocol to standard quitline treatment to prevent relapse among recently quit smokers. Design: Parallel randomised controlled trial with three arms: standard quitline, standard plus technology enhanced quitline with 10 risk assessments (TEQ-10), standard plus 20 TEQ assessments (TEQ-20). Setting: Quit For Life (QFL) programme. Participants: 1785 QFL enrolees through 19 employers or health plans who were 24+ h quit. Interventions: QFL is a 5-call telephone-based cessation programme including medications and web-based support. TEQ interventions included 10 or 20 IVR-delivered relapse risk assessments over 8 weeks with automated transfer to counselling for those at risk. Main outcome measures: Self-reported 7-day and 30-day abstinence assessed at 6-month and 12-month post-enrolment (response rates: 61{\%} and 59{\%}, respectively). Missing data were imputed. Results: 1785 were randomised (standard n=592, TEQ-10 n=602, TEQ-20 n=591). Multiple imputation-derived, intent-to-treat 30-day quit rates (95{\%} CI) at 6 months were 59.4{\%} (53.7{\%} to 63.8{\%}) for standard, 62.3{\%} (57.7{\%} to 66.9{\%}) for TEQ-10, 59.4{\%} (53.7{\%} to 65.1{\%}) for TEQ-20 and 30-day quit rates at 12 months were 61.2{\%} (55.6{\%} to 66.8{\%}) for standard, 60.6{\%} (56.0{\%} to 65.2{\%}) for TEQ-10, 54.9{\%} (49.0{\%} to 60.9{\%}) for TEQ-20. There were no significant differences in quit rates. 73.3{\%} of TEQ participants were identified as at-risk by IVR assessments; on average, participants completed 0.41 IVR-transferred counselling calls. Positive risk assessments identified participants less likely (OR=0.56, 95{\%} CI 0.42 to 0.76) to be abstinent at 6 months. Conclusions: Standard treatment was highly effective, with 61{\%} remaining abstinent at 12 months using multiple imputation intent-to-treat (intent-to-treat missing=smoking quit rate: 38{\%}). TEQ assessments identified quitters at risk for relapse. However, adding IVR-transferred counselling did not yield higher quit rates. Research is needed to determine if alternative designs can improve outcomes.",
author = "McDaniel, {Anna M.} and Vickerman, {Katrina A.} and Stump, {Timothy E.} and Patrick Monahan and Fellows, {Jeffrey L.} and Weaver, {Michael T.} and Carlini, {Beatriz H.} and Victoria Champion and Zbikowski, {Susan M.}",
year = "2015",
doi = "10.1136/bmjopen-2014-007260",
language = "English (US)",
volume = "5",
journal = "BMJ Open",
issn = "2044-6055",
publisher = "BMJ Publishing Group",
number = "6",

}

TY - JOUR

T1 - A randomised controlled trial to prevent smoking relapse among recently quit smokers enrolled in employer and health plan sponsored quitlines

AU - McDaniel, Anna M.

AU - Vickerman, Katrina A.

AU - Stump, Timothy E.

AU - Monahan, Patrick

AU - Fellows, Jeffrey L.

AU - Weaver, Michael T.

AU - Carlini, Beatriz H.

AU - Champion, Victoria

AU - Zbikowski, Susan M.

PY - 2015

Y1 - 2015

N2 - Objective: To test adding an interactive voice response (IVR)-supported protocol to standard quitline treatment to prevent relapse among recently quit smokers. Design: Parallel randomised controlled trial with three arms: standard quitline, standard plus technology enhanced quitline with 10 risk assessments (TEQ-10), standard plus 20 TEQ assessments (TEQ-20). Setting: Quit For Life (QFL) programme. Participants: 1785 QFL enrolees through 19 employers or health plans who were 24+ h quit. Interventions: QFL is a 5-call telephone-based cessation programme including medications and web-based support. TEQ interventions included 10 or 20 IVR-delivered relapse risk assessments over 8 weeks with automated transfer to counselling for those at risk. Main outcome measures: Self-reported 7-day and 30-day abstinence assessed at 6-month and 12-month post-enrolment (response rates: 61% and 59%, respectively). Missing data were imputed. Results: 1785 were randomised (standard n=592, TEQ-10 n=602, TEQ-20 n=591). Multiple imputation-derived, intent-to-treat 30-day quit rates (95% CI) at 6 months were 59.4% (53.7% to 63.8%) for standard, 62.3% (57.7% to 66.9%) for TEQ-10, 59.4% (53.7% to 65.1%) for TEQ-20 and 30-day quit rates at 12 months were 61.2% (55.6% to 66.8%) for standard, 60.6% (56.0% to 65.2%) for TEQ-10, 54.9% (49.0% to 60.9%) for TEQ-20. There were no significant differences in quit rates. 73.3% of TEQ participants were identified as at-risk by IVR assessments; on average, participants completed 0.41 IVR-transferred counselling calls. Positive risk assessments identified participants less likely (OR=0.56, 95% CI 0.42 to 0.76) to be abstinent at 6 months. Conclusions: Standard treatment was highly effective, with 61% remaining abstinent at 12 months using multiple imputation intent-to-treat (intent-to-treat missing=smoking quit rate: 38%). TEQ assessments identified quitters at risk for relapse. However, adding IVR-transferred counselling did not yield higher quit rates. Research is needed to determine if alternative designs can improve outcomes.

AB - Objective: To test adding an interactive voice response (IVR)-supported protocol to standard quitline treatment to prevent relapse among recently quit smokers. Design: Parallel randomised controlled trial with three arms: standard quitline, standard plus technology enhanced quitline with 10 risk assessments (TEQ-10), standard plus 20 TEQ assessments (TEQ-20). Setting: Quit For Life (QFL) programme. Participants: 1785 QFL enrolees through 19 employers or health plans who were 24+ h quit. Interventions: QFL is a 5-call telephone-based cessation programme including medications and web-based support. TEQ interventions included 10 or 20 IVR-delivered relapse risk assessments over 8 weeks with automated transfer to counselling for those at risk. Main outcome measures: Self-reported 7-day and 30-day abstinence assessed at 6-month and 12-month post-enrolment (response rates: 61% and 59%, respectively). Missing data were imputed. Results: 1785 were randomised (standard n=592, TEQ-10 n=602, TEQ-20 n=591). Multiple imputation-derived, intent-to-treat 30-day quit rates (95% CI) at 6 months were 59.4% (53.7% to 63.8%) for standard, 62.3% (57.7% to 66.9%) for TEQ-10, 59.4% (53.7% to 65.1%) for TEQ-20 and 30-day quit rates at 12 months were 61.2% (55.6% to 66.8%) for standard, 60.6% (56.0% to 65.2%) for TEQ-10, 54.9% (49.0% to 60.9%) for TEQ-20. There were no significant differences in quit rates. 73.3% of TEQ participants were identified as at-risk by IVR assessments; on average, participants completed 0.41 IVR-transferred counselling calls. Positive risk assessments identified participants less likely (OR=0.56, 95% CI 0.42 to 0.76) to be abstinent at 6 months. Conclusions: Standard treatment was highly effective, with 61% remaining abstinent at 12 months using multiple imputation intent-to-treat (intent-to-treat missing=smoking quit rate: 38%). TEQ assessments identified quitters at risk for relapse. However, adding IVR-transferred counselling did not yield higher quit rates. Research is needed to determine if alternative designs can improve outcomes.

UR - http://www.scopus.com/inward/record.url?scp=84937201374&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84937201374&partnerID=8YFLogxK

U2 - 10.1136/bmjopen-2014-007260

DO - 10.1136/bmjopen-2014-007260

M3 - Article

C2 - 26124508

AN - SCOPUS:84937201374

VL - 5

JO - BMJ Open

JF - BMJ Open

SN - 2044-6055

IS - 6

M1 - e007260

ER -