ABSTRACT
BACKGROUND: The wide scale and severity of consequences of tobacco use, benefits derived from cessation, low rates of intervention by healthcare professionals, and new opportunities stemming from novel communications technologies are the main factors motivating this project. Thus, the purpose of this study is to assess the effectiveness of an intervention that helps people cease smoking and increase their nicotine abstinence rates in the long term via a chat-bot, compared to usual practice, utilizing a chemical validation at 6 months. METHODS: Design: Randomized, controlled, multicentric, pragmatic clinical trial, with a 6-month follow-up. SETTING: Healthcare centers in the public healthcare system of the Community of Madrid (Madrid Regional Health Service). PARTICIPANTS: Smokers > 18 years of age who attend a healthcare center and accept help to quit smoking in the following month. N = 460 smokers (230 per arm) who will be recruited prior to randomization. Intervention group: use of a chat-bot with evidence-based contents to help quit smoking. CONTROL GROUP: Usual treatment (according to the protocol for tobacco cessation by the Madrid Regional Health Service Main variable: Continuous nicotine withdrawal with chemical validation (carbon monoxide in exhaled air). Intention-to-treat analysis. Difference between groups in continuous abstinence rates at 6 months with their corresponding 95% confidence interval. A logistic regression model will be built to adjust for confounding factors. RESULTS: First expected results in January 2020. DISCUSSION: Providing science-based evidence on the effectiveness of clinical interventions via information technologies, without the physical presence of a professional, is essential. In addition to being more efficient, the characteristics of these interventions can improve effectiveness, accessibility, and adherence to treatment. From an ethics perspective, this new type of intervention must be backed by scientific evidence to circumvent pressures from the market or particular interests, improve patient safety, and follow the standards of correct practices for clinical interventions. TRIAL REGISTRATION: ClinicalTrials.gov, reference number NCT03445507.
Subject(s)
Artificial Intelligence , Smoking Cessation/methods , Software , Telemedicine/methods , Adult , Cell Phone , Female , Humans , Male , Mobile Applications , Primary Health Care , Smoking/therapy , SpainABSTRACT
No disponible
Subject(s)
Humans , Tobacco Use Disorder/therapy , Clinical Protocols , Primary Health CareABSTRACT
No disponible
Subject(s)
Humans , Counseling/methods , Tobacco Use Cessation/methods , Clinical Trials as Topic , Counseling/standards , Patient Education as Topic , Tobacco Use DisorderABSTRACT
OBJECTIVE: To analyse medical care for terminal cancer patients (TCP) in a health district. DESIGN: A descriptive, crossover study. SETTING: primary care in an urban environment. PATIENTS: 227 patients who died of cancer between January 1994 and June 1995 and who came under the nine primary care teams (PCT) studied. MEASUREMENTS AND MAIN RESULTS: Information bases: mortality records and clinical histories from the PCT. VARIABLES STUDIED: age, sex, type of tumour, date of diagnosis of terminal illness, whether treated or not with morphine and (if so) the doses, place of death and the care activity engendered. Univariant analysis with standard means and deviations for the quantitative variables, frequencies for the qualitative ones and the Chi squared test for comparison. 64% were male. Most common neoplasias were, in order: lung, colon and stomach. 78 patients (49%) received morphine treatment, datum related to age. Average morphine dose was 80 mg in 24 hours. CONCLUSIONS: Patient treatment was inadequate because morphine, the lodestone of terminal cancer care, was insufficiently used. In contradiction with WHO recommendations, most patients died in hospital. Specific training programmes should be created for PC professionals with the aim of improving their handling of terminal cancer patients.
