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Stage Ib Trial of mSMART With Varenicline (mSMART-v)

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ClinicalTrials.gov Identifier: NCT03069768
Recruitment Status : Withdrawn (Unable to obtain varenicline to provide to participants)
First Posted : March 3, 2017
Last Update Posted : April 17, 2018
Sponsor:
Collaborators:
Intelligent Automation, Inc.
National Institute on Drug Abuse (NIDA)
Information provided by (Responsible Party):
Duke University

Brief Summary:
The primary aim of this study is to conduct a 60-patient feasibility, acceptability, and preliminary efficacy study of mSMART (Mobile App based Personalized Solutions and Tools for Medication Adherence of Rx Pill), a smartphone application ("app") for improving medication adherence among substance users. The investigators will compare 2 groups of cigarette smokers undergoing a quit attempt with varenicline (Chantix): a) an experimental group using the mSMART app on their smartphone and a MEMS Cap (Medication Event Monitoring System, a smart pillbox that will a record a date and time-stamped medication event whenever pill box is opened and closed, and thus allow for primary measurement of medication adherence) and b) a control group using the MEMS Cap and mobile web-based surveys on their smartphone.

Condition or disease Intervention/treatment Phase
Nicotine Dependence Device: mSMART Drug: Chantix Phase 1

Detailed Description:
Poor medication adherence (a) results in poorer treatment outcome and (b) accounts for $100 to $290 billion in U.S. healthcare costs annually. Therefore, interventions that target medication adherence are increasingly crucial for patient care and cost-effectiveness. Mobile technologies such as smartphones are increasingly ubiquitous and affordable in the U.S., and can be integrated to augment medication adherence. mSMART is a smartphone application that targets medication adherence in substance users. The study team has developed and assessed mSMART in a Stage Ia trial among 9 non-treatment seeking cigarette smokers. mSMART provides psychoeducation about medication (e.g., dosage, benefits, side-effects), assessment of medication compliance and characteristics associated with substance use, provides reminders to take medications, and conducts real-time medication event feedback intervention. The aim of the current study is to extend findings from the Stage Ia trial assessing preliminary feasibility and acceptability of mSMART for cigarette smokers. In the proposed study, the investigators will conduct a Stage Ib for the continued development of mSMART in an occupational wellness setting. This will also include a study of the feasibility, acceptability, and preliminary efficacy of mSMART for treatment seeking cigarette smokers undergoing a quit attempt. A sample of 60 cigarette smokers will be given varenicline (Chantix) and randomized to either a control condition (i.e., use of MEMS Cap, a smart pillbox that records instances that the pill bottle is opened) or treatment condition (i.e., use of MEMS Cap and mSMART) over a 12 week treatment period. The primary hypothesis is that the treatment group will achieve higher levels of medication adherence assessed via MEMS Cap. The secondary hypothesis is that the treatment group will also yield lower levels of salivary cotinine at week 12 assessment, indicating higher rates of smoking abstinence relative to the control group. Findings from the current study will inform the continued development of mSMART as an intervention to enhance substance use treatment outcome, including other forms of substance use besides cigarette smoking.

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 0 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Other
Official Title: Stage Ib Trial of mSMART With Varenicline
Estimated Study Start Date : April 2018
Estimated Primary Completion Date : January 2019
Estimated Study Completion Date : June 2019

Resource links provided by the National Library of Medicine


Arm Intervention/treatment
Experimental: mSMART
Smokers in this group will have the mSMART application installed on their smartphones. The mSMART application will provide information about varenicline (Chantix) and reminders when it's time to take the medication.
Device: mSMART
A smartphone application that targets medication adherence in substance users, providing information and reminders and tracking medication usage and factors interfering with adherence.
Other Names:
  • mSMART app
  • mSMART Smartphone Application

Drug: Chantix
For the first 3 days smokers in this group will receive treatment with Chantix at a dose of 0.5 mg once per day followed by 0.5 mg twice a day for the remaining 4 days of that week. Subsequently, the dose will be 1 mg twice per day, and will remain at that dose for the remainder of the 12-week active treatment duration.
Other Name: Varenicline

Active Comparator: Control
Smokers in this group will not be given the mSMART application.
Drug: Chantix
For the first 3 days smokers in this group will receive treatment with Chantix at a dose of 0.5 mg once per day followed by 0.5 mg twice a day for the remaining 4 days of that week. Subsequently, the dose will be 1 mg twice per day, and will remain at that dose for the remainder of the 12-week active treatment duration.
Other Name: Varenicline




Primary Outcome Measures :
  1. Adherence to smoking cessation medication as assessed via Medication Event Monitoring System (MEMS) [ Time Frame: Week 12 ]
    The MEMS Cap, placed on the subject's medication bottle, will document the number of times the bottle is opened per day, totalled at the end of study

  2. Acceptability of mSMART based on responses to an exit interview [ Time Frame: Week 12 ]
    Acceptability of mSMART will be based on responses to an exit interview at the end of the study (Visit 2). Questionnaire asks for agreement with statements relating to acceptability of the app. Response options will be quantified on a Likert scale (1 = not at all, 2 = somewhat, 3 = moderately, 4 = extremely). Example question: What was your overall satisfaction with mSMART?

  3. Feasibility of mSMART based on frequency of participant use of the app [ Time Frame: Week 12 ]
    Feasibility of mSMART will be based on frequency of participant use of the app, totalled at the end of the study.


Secondary Outcome Measures :
  1. Adherence to smoking cessation medication indicated by smoking abstinence [ Time Frame: Week 12 ]
    Adherence to smoking cessation medication will be evaluated by assessing a biochemical (salivary) measure of participant's cotinine level at the end of the 12 week intervention period which will assess smoking abstinence.

  2. Adherence to smoking cessation medication indicated by mSMART medication event data [ Time Frame: Week 12 ]
    Adherence to smoking cessation medication analyzed using mSMART's medication event data from use of Medication Aide widget (a component of mSMART involving a smartphone camera-based medication identification and identification-based medication event technology developed by Intelligent Automation, Inc.) in the experimental group.



Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years to 65 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Interested in taking varenicline (Chantix) with the intention to quit smoking in the next 3 months
  • Has an Android smartphone (using v5.x.x or lollipop) or Apple smartphone (iPhone) Operating System (iOS) (using v6.0)
  • 18-65 years of age

Exclusion Criteria:

  • Unwillingness to be randomized to either treatment condition
  • Subjects who have currently been taking varenicline for more than 15 days
  • Currently pregnant or plan on becoming pregnant (females only)

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03069768


Locations
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United States, North Carolina
Duke Health Behavior Neuroscience Research Lab
Durham, North Carolina, United States, 27705
Sponsors and Collaborators
Duke University
Intelligent Automation, Inc.
National Institute on Drug Abuse (NIDA)
Investigators
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Principal Investigator: F. Joseph McClernon, Ph.D. Duke University

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Responsible Party: Duke University
ClinicalTrials.gov Identifier: NCT03069768     History of Changes
Other Study ID Numbers: Pro00080336
271201400069C-0-0-1 ( U.S. NIH Grant/Contract )
First Posted: March 3, 2017    Key Record Dates
Last Update Posted: April 17, 2018
Last Verified: April 2018

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Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No

Keywords provided by Duke University:
Nicotine addiction
Cigarette smoking
Smoking cessation
Quit smoking

Additional relevant MeSH terms:
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Varenicline
Tobacco Use Disorder
Substance-Related Disorders
Chemically-Induced Disorders
Mental Disorders
Nicotinic Agonists
Cholinergic Agonists
Cholinergic Agents
Neurotransmitter Agents
Molecular Mechanisms of Pharmacological Action
Physiological Effects of Drugs