Your browser doesn't support javascript.
loading
Impact of Adding Telephone-Based Care Coordination to Standard Telephone-Based Smoking Cessation Counseling Post-hospital Discharge: a Randomized Controlled Trial.
Ellerbeck, Edward F; Cox, Lisa Sanderson; Hui, Siu-Kuen Azor; Keighley, John; Hutcheson, Tresza D; Fitzgerald, Sharon A; Cupertino, A Paula; Greiner, K Allen; Rigotti, Nancy A; Miller, Nancy Houston; Rabius, Vance; Richter, Kimber P.
Affiliation
  • Ellerbeck EF; Department of Population Health, University of Kansas Medical Center, 3901 Rainbow Blvd., MS 1008, Kansas City, KS, 66160, USA. eellerbe@kumc.edu.
  • Cox LS; Department of Population Health, University of Kansas Medical Center, 3901 Rainbow Blvd., MS 1008, Kansas City, KS, 66160, USA.
  • Hui SA; Philadelphia Department of Public Health, Philadelphia, PA, USA.
  • Keighley J; Department of Biostatistics, University of Kansas Medical Center, Kansas City, KS, USA.
  • Hutcheson TD; Department of Population Health, University of Kansas Medical Center, 3901 Rainbow Blvd., MS 1008, Kansas City, KS, 66160, USA.
  • Fitzgerald SA; Department of Population Health, University of Kansas Medical Center, 3901 Rainbow Blvd., MS 1008, Kansas City, KS, 66160, USA.
  • Cupertino AP; Department of Population Health, University of Kansas Medical Center, 3901 Rainbow Blvd., MS 1008, Kansas City, KS, 66160, USA.
  • Greiner KA; Department of Family Medicine, University of Kansas Medical Center, Kansas City, KS, USA.
  • Rigotti NA; Division of General Internal Medicine, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA.
  • Miller NH; The LifeCare Company, Menlo Park, CA, USA.
  • Rabius V; Department of Behavioral Science, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
  • Richter KP; Department of Population Health, University of Kansas Medical Center, 3901 Rainbow Blvd., MS 1008, Kansas City, KS, 66160, USA.
J Gen Intern Med ; 34(12): 2804-2811, 2019 12.
Article in En | MEDLINE | ID: mdl-31367875
BACKGROUND: Cessation counseling and pharmacotherapy are recommended for hospitalized smokers, but better coordination between cessation counselors and providers might improve utilization of pharmacotherapy and enhance smoking cessation. OBJECTIVE: To compare smoking cessation counseling combined with care coordination post-hospitalization to counseling alone on uptake of pharmacotherapy and smoking cessation. DESIGN: Unblinded, randomized clinical trial PARTICIPANTS: Hospitalized smokers referred from primarily rural hospitals INTERVENTIONS: Counseling only (C) consisted of telephone counseling provided during the hospitalization and post-discharge. Counseling with care coordination (CCC) provided similar counseling supplemented by feedback to the smoker's health care team and help for the smoker in obtaining pharmacotherapy. At 6 months post-hospitalization, persistent smokers were re-engaged with either CCC or C. MAIN MEASURES: Utilization of pharmacotherapy and smoking cessation at 3, 6, and 12 months post-discharge. KEY RESULTS: Among 606 smokers randomized, 429 (70.8%) completed the 12-month assessment and 580 (95.7%) were included in the primary analysis. Use of any cessation pharmacotherapy between 0 and 6 months (55.2%) and between 6 and 12 months (47.1%) post-discharge was similar across treatment arms though use of prescription-only pharmacotherapy between months 6-12 was significantly higher in the CCC group (30.1%) compared with the C group (18.6%) (RR, 1.61 (95% CI, 1.08, 2.41)). Self-reported abstinence rates of 26.2%, 20.3%, and 23.4% at months 3, 6, and 12, respectively, were comparable across the two treatment arms. Of those smoking at month 6, 12.5% reported abstinence at month 12. Validated smoking cessation at 12 months was 19.3% versus 16.9% in the CCC and C groups, respectively (RR, 1.13 (95% CI, 0.80, 1.61)). CONCLUSION: Supplemental care coordination, provided by counselors outside of the health care team, failed to improve smoking cessation beyond that achieved by cessation counseling alone. Re-engagement of smokers 6 months post-discharge can lead to new quitters, at which time care coordination might facilitate use of prescription medications. TRIAL REGISTRATION: NCT01063972.
Subject(s)
Key words

Full text: 1 Database: MEDLINE Main subject: Patient Discharge / Telephone / Smoking Cessation / Telemedicine / Continuity of Patient Care / Counseling Type of study: Clinical_trials / Observational_studies / Prognostic_studies Limits: Adult / Female / Humans / Male / Middle aged Language: En Journal: J Gen Intern Med Journal subject: MEDICINA INTERNA Year: 2019 Type: Article Affiliation country: United States

Full text: 1 Database: MEDLINE Main subject: Patient Discharge / Telephone / Smoking Cessation / Telemedicine / Continuity of Patient Care / Counseling Type of study: Clinical_trials / Observational_studies / Prognostic_studies Limits: Adult / Female / Humans / Male / Middle aged Language: En Journal: J Gen Intern Med Journal subject: MEDICINA INTERNA Year: 2019 Type: Article Affiliation country: United States