Medical Student Counseling for Hospitalized Patients Addicted to Tobacco
কীওয়ার্ডস
বিমূর্ত
বর্ণনা
India is the 2nd largest consumer of tobacco in the world, with 275 million Indians using tobacco. Each hospitalization is an opportunity for providers to motivate their patients to quit. However, the Indian medical curriculum typically offers little training in the skills required to successfully counsel a patient to quit smoking. The investigators hypothesize that trained medical students can increase subsequent quit rates among hospitalized smokers, while acquiring skills in tobacco cessation counseling.
The investigators propose a 2-armed multicenter randomized controlled trial (RCT) that will compare the effectiveness of standard hospital practice versus a medical student-guided smoking cessation program initiated inpatient and continued for three months after discharge. The target study population includes current smokers admitted to the general medicine, pulmonary and cardiology wards. These patients will be randomized to receive either usual care or the intervention. The intervention group will receive both inpatient and longitudinal post-discharge telephone counseling by medical students who have successfully completed a training workshop in tobacco cessation counseling and pharmacotherapy. The students can also recommend nicotine replacement therapy (NRT) to the patient if indicated. The control group will receive counseling and/or NRT at the discretion of the treating physician. They will not receive phone based counseling after discharge.
Patients from both groups will be asked to report their quit status 6 months after enrolment.
তারিখ
| সর্বশেষ যাচাই করা হয়েছে: | 01/31/2020 |
| প্রথম জমা দেওয়া: | 04/13/2018 |
| আনুমানিক তালিকাভুক্তি জমা দেওয়া হয়েছে: | 05/08/2018 |
| প্রথম পোস্ট: | 05/10/2018 |
| সর্বশেষ আপডেট জমা দেওয়া হয়েছে: | 02/09/2020 |
| সর্বশেষ আপডেট পোস্ট: | 02/10/2020 |
| আসল অধ্যয়ন শুরুর তারিখ: | 12/11/2018 |
| আনুমানিক প্রাথমিক সমাপ্তির তারিখ: | 08/31/2020 |
| আনুমানিক অধ্যয়ন সমাপ্তির তারিখ: | 08/31/2020 |
অবস্থা বা রোগ
হস্তক্ষেপ / চিকিত্সা
Behavioral: Intervention
পর্যায়
বাহু গ্রুপ
| বাহু | হস্তক্ষেপ / চিকিত্সা |
|---|---|
| Experimental: Intervention Smoking Cessation counseling by trained medical students with or without Nicotine Replacement Therapy | Behavioral: Intervention Trained medical students will visit patients inpatient while hospitalized and provide smoking cessation counseling and recommend Nicotine Replacement Therapy. They will continue to follow these patients for 2 months after discharge and provide telephone-based counseling. |
| No Intervention: Control The control group will receive counseling and/or NRT at the discretion of the treating physician. |
যোগ্যতার মানদণ্ড
| বয়স অধ্যয়নের জন্য যোগ্য | 18 Years প্রতি 18 Years |
| লিঙ্গ অধ্যয়নের জন্য যোগ্য | All |
| স্বাস্থ্যকর স্বেচ্ছাসেবীদের গ্রহণ করে | হ্যাঁ |
| নির্ণায়ক | Inclusion Criteria: 1. Patients age 18-70 years old, who are admitted to the medical, and if required surgical wards. 2. Patients must be current smokers (cigarettes and/or bidis) at the time of admission or report having smoked at all in the last 4 weeks prior to admission (to account for changes in behaviour during illness). 3. Patients living within 10 Km radius of the hospital. Exclusion Criteria: 1. Unwilling to participate 2. Patients who use only non-smoked tobacco will be excluded. 3. Patients who are are daily alcohol users, daily cannabis or psychotropic drug users. 4. Patients who do not have a telephone/ unable to follow up 5. Patients unable to understand the local/common language 6. Patients with psychiatric conditions rendering them incapable of interacting with the providers 7. Medically unstable patients 8. Patients with expected hospital stay <24 hours 9. Patients with life expectancy < 12 months 10. Pregnant patients 11. Patients currently participating in a tobacco cessation program 12. Prior participation in this trial during another hospitalisation |
ফলাফল
প্রাথমিক ফলাফল ব্যবস্থা
1. Biochemically verified 7 day quit rate measured 6 months after enrolment. [6 months from enrolment]
মাধ্যমিক ফলাফলের ব্যবস্থা
1. Biochemically verified 90 day quit rate, measured 6 months after enrolment [6 months from enrolment]
2. Number of patients achieving a 50% reduction in the number of cigarettes /bidis smoked in a week, measured at 2 and 6 months after enrolment [2 and 6 months from enrolment]
3. Correlation between verified quit rates at 6 months and FTND scores at enrolment [6 months from enrolment]
4. Number of patients who report having quit smoking in the last 7 days (irrespective of biochemical verification) [2 and 6 months from enrolment]
5. Agreement between self reported quit 7 day quit rate and biochemically verified 7 day quit rate, measured at 6 months from enrolment [6 months from enrolment]
6. No of patients who have refrained from using smokeless tobacco in the last 7 days, measured at 6 months. [6 months from enrolment]
7. Pre-post analysis of medical student knowledge about counseling techniques and pharmacotherapy [6 weeks and 12 months after training]
8. Qualitative analysis of student attitudes towards smoking cessation counseling [12 months after training]
9. Qualitative analysis of the feasibility and acceptability of the intervention [12 months after training]
অন্যান্য ফলাফলের ব্যবস্থা
1. Number of eligible patients that receive inpatient counseling and atleast 3 follow up calls [2 months from enrolment]
2. Number of patients who use any form of cessation pharmacotherapy within the first 2 months [2 months from enrolment]
3. Number of patients enrolled in the study that are available for follow up at 6 months [6 months from enrolment]
