Medical Student INtervention to Promote Effective Nicotine Dependence and Tobacco HEalthcare (MIND-THE-GAP)
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|ClinicalTrials.gov Identifier: NCT02601599|
Recruitment Status : Completed
First Posted : November 10, 2015
Last Update Posted : March 10, 2017
Background: Smoking counselling during hospitalisation with post-discharge follow-up increases quitting. However, provision of cessation care for hospitalised patients is suboptimal. Students are potentially an untapped resource for providing cessation advice, but no studies have investigated this.
Aim: To determine if medical students can encourage motivation to stop smoking (MTSS; primary outcome) in hospitalised smokers .
Design: 2-arm RCT Setting: RCSI (www.rcsi.ie) and Connolly Hospital (www.hse.ie/eng/services/list/3/hospitals/Connolly/).
Participants: Inpatient smokers. Intervention and procedures: 60 graduate medical students will receive standardised motivational interviewing training in the provision of cessation advice. Each student will be randomly assigned to counsel ~1-3 smokers each, including an individual in-hospital, face-to-face session and post-discharge phone counselling. Training and implementation will cover Sept-2015-May-2016. Smokers will be randomised to 'usual care' (n~90), or intervention (n~90, student-delivered motivational interviewing). A researcher will enable recruitment and follow-up, and conduct a qualitative evaluation of programme participants.
|Condition or disease||Intervention/treatment||Phase|
|Smoking||Behavioral: Motivational interviewing||Not Applicable|
|Study Type :||Interventional (Clinical Trial)|
|Actual Enrollment :||67 participants|
|Intervention Model:||Parallel Assignment|
|Masking:||None (Open Label)|
|Primary Purpose:||Supportive Care|
|Official Title:||Medical Student INtervention to Promote Effective Nicotine Dependence and Tobacco HEalthcare: GrAduate Entry Programme (MIND-THE-GAP) Feasibility Randomised Trial|
|Actual Study Start Date :||November 2015|
|Actual Primary Completion Date :||December 2016|
|Actual Study Completion Date :||December 2016|
Motivational interviewing The medical student will deliver a 15 minute consultation with the patient. The goals of this consultation will be to enhance the patient's motivation and self-efficacy regarding quitting, educate the patient about effective behavioral and pharmacological cessation strategies, and collaboratively elicit a plan to stay quit after discharge. Patients will be offered the opportunity to receive a consultation from the attending physician to determine eligibility for pharmacotherapy. Patients who elect to receive this consult with have a coloured sticker placed by the medical student on the medical chart requesting a consultation.
Behavioral: Motivational interviewing
The medical student will deliver a brief (approximately 15 minute) consultation with the patient that is based on principles of social cognitive theory and motivational interviewing. The goals of this consultation will be to enhance the patient's motivation and self-efficacy regarding quitting, and collaboratively elicit a plan to stay quit after discharge. Patients will be offered the opportunity to receive a consultation from the attending physician to determine eligibility for pharmacotherapy (via a chart sticker).
Each student will counsel 1-3 smokers each over the 8-month academic period, with student training and intervention staggered over this time. Students will also re-contact the smoker at 1-week post-discharge via telephone or personal follow-up, to provide further support.
No Intervention: Usual care
This group will not receive student contact, but may be counselled by the smoking cessation officer or other Connolly staff as per normal procedures.
- Change in Motivation to Stop Smoking Scale (MTSS) [ Time Frame: Repeated measures: MTSS scores at baseline, 1-week, 3- and 6-month follow-up. ]Repeated measures: MTSS scores at baseline, 1-week, 3- and 6-month follow-up.
- Change in motivation to quit [ Time Frame: Repeated measures: single item scores at baseline, 1-week, 3- and 6-month follow-up. ]If, on a scale of 1 to 10, 1 is not at all motivated to give up smoking and 10 is 100% motivated to give up, what number would you give yourself at the moment?
- Proportion of patients who receive a prescription for a cessation medication at the time of discharge [ Time Frame: By discharge, an average of 5-10 days post-admission ]The proportion of patients who receive a prescription for a cessation medication at the time of discharge, assessed via medical chart audit;
- proportion of patients who report any use of a prescribed or over-the-counter cessation medication [ Time Frame: at 3- and 6-months discharge ]the proportion of patients who report any use of a prescribed or over-the-counter cessation medication, of an approved cessation pharmacotherapy, including nicotine patch, gum, lozenge, inhaler, mouth spray, Champix, or Zyban at 1- and 6-months discharge
- proportion of attending physicians who prescribe cessation medication during the hospitalisation [ Time Frame: During hospitalisation (baseline) ]the proportion of attending physicians who prescribe cessation medication during the hospitalisation (to be obtained by medical chart audit);
- 7-day point prevalent abstinence rates [ Time Frame: 3- and 6-months ]7-day point prevalent abstinence rates assessed at both 3- and 6-months by self-report
- Perceived student efficacy [ Time Frame: 3- and 6-months ]Single items survey: How helpful was the support that you received from the medical student?" [not at all, a little bit, somewhat, quite a bit, or very much]?"
- Perceived student knowledge [ Time Frame: 3- and 6-months ]Single item survey: How knowledgeable was the medical student about quitting smoking? [not at all, a little bit, somewhat, quite a bit, or very much]
- Quit attempts [ Time Frame: 3- and 6-months ]
Three questionnaire items:
- In the past one/six months, have you quit smoking? Yes/No
- If no, in the past one/six months have you attempted to quit smoking? Yes/No
- If yes, how many times have you tried to quit in the past three/six months? ______
- Professional advice [ Time Frame: 3- and 6 months ]One questionnaire item: In the past 3/6 months since your hospital admission, did a doctor or health professional discuss ways of giving up smoking with you?
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02601599
|Connolly Hospital Blanchardstown|
|Study Director:||Seamus Sreenan||RCSI and Connolly Hospital|
|Study Director:||Liam Cormican||RCSI and Connolly Hospital|
|Study Director:||Ken Ward||University of Memphis|
|Study Director:||Lisa Mellon, PhD||RCSI|
|Study Director:||Ronan Conroy||RCSI|
|Study Director:||Anne Hickey, PhD||RCSI|
|Study Director:||Sinead Stynes||Connolly Hospital|
|Principal Investigator:||Frank Doyle, PhD||RCSI|
|Study Director:||GEP IC1||RCSI students|