Using "warm handoffs" to link hospitalized smokers with tobacco treatment after discharge: study protocol of a randomized controlled trial.
Using "warm handoffs" to link hospitalized smokers with tobacco treatment after discharge: study protocol of a randomized controlled trial.
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DOI：
10.1186/1745-6215-13-127
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发表时间：
2012-08-01
期刊：
影响因子：
2.5
通讯作者：
Cook DJ
中科院分区：
文献类型：
--
作者：
Richter KP;Faseru B;Mussulman LM;Ellerbeck EF;Shireman TI;Hunt JJ;Carlini BH;Preacher KJ;Ayars CL;Cook DJ
出院后支持是住院吸烟者有效治疗的关键组成部分，但很少有医院提供这种支持。许多医院和护理机构通过传真将吸烟者转介到戒烟热线进行跟进；然而，只有不到一半的传真转介吸烟者成功联系并登记了戒烟热线服务。“温暖移交”是一种新的护理过渡方法，医疗保健提供者通过面对面或电话转接的方式，直接将有药物滥用问题的患者与专家联系起来。温暖移交为这些弱势群体实现了非常高的治疗登记率。这项名为“提高住院患者戒烟专线利用率”的研究的目的是确定将住院吸烟者与戒烟专线联系起来的热转接和传真转介的有效性和成本效益。这项研究采用双臂、个人随机设计。它以堪萨斯州的两家大型医院为背景，这两家医院的工作人员都有专门的烟草治疗干预者。在每个地点，希望在出院后继续戒烟的吸烟者将被随机分配到小组。对于传真组的患者，工作人员将提供标准的住院干预，并将传真转介患者到州烟草戒烟热线接受出院后的咨询。对于温暖移交组的患者，工作人员将提供短暂的住院干预和立即的热情移交：工作人员将拨打州退出热线，通知他们来自堪萨斯州的温暖移交住院患者正在通话，然后将电话转接到患者的移动电话或床边医院电话，以便退出热线注册和初始咨询会议。在QuiLine会议之后，医院工作人员提供了一个简短的回访。结果衡量标准将在注册后1、6和12个月的 进行评估。衡量成本是为了支持成本效益分析。我们假设，与传真转诊相比，热移交将改善烟草治疗的护理过渡，招募更多的参与者参加戒烟服务，并导致更高的戒烟率。我们还假设，从社会角度来看，温暖的移交将更具成本效益。如果成功，该项目将提供一个低成本的解决方案，更有效地将数百万住院吸烟者与有效的门诊治疗联系起来--否则，吸烟者可能会在向门诊护理的过渡中迷失。临床试验注册NCT01305928
Post-discharge support is a key component of effective treatment for hospitalized smokers, but few hospitals provide it. Many hospitals and care settings fax-refer smokers to quitlines for follow-up; however, less than half of fax-referred smokers are successfully contacted and enrolled in quitline services. “Warm handoff” is a novel approach to care transitions in which health care providers directly link patients with substance abuse problems with specialists, using face-to-face or phone transfer. Warm handoff achieves very high rates of treatment enrollment for these vulnerable groups. The aim of this study—“EQUIP” (Enhancing Quitline Utilization among In-Patients)—is to determine the effectiveness, and cost-effectiveness, of warm handoff versus fax referral for linking hospitalized smokers with tobacco quitlines. This study employs a two-arm, individually randomized design. It is set in two large Kansas hospitals that have dedicated tobacco treatment interventionists on staff. At each site, smokers who wish to remain abstinent after discharge will be randomly assigned to groups. For patients in the fax group, staff will provide standard in-hospital intervention and will fax-refer patients to the state tobacco quitline for counseling post-discharge. For patients in the warm handoff group, staff will provide brief in-hospital intervention and immediate warm handoff: staff will call the state quitline, notify them that a warm handoff inpatient from Kansas is on the line, then transfer the call to the patients’ mobile or bedside hospital phone for quitline enrollment and an initial counseling session. Following the quitline session, hospital staff provides a brief check-back visit. Outcome measures will be assessed at 1, 6, and 12 months post enrollment. Costs are measured to support cost-effectiveness analyses. We hypothesize that warm handoff, compared to fax referral, will improve care transitions for tobacco treatment, enroll more participants in quitline services, and lead to higher quit rates. We also hypothesize that warm handoff will be more cost-effective from a societal perspective. If successful, this project offers a low-cost solution for more efficiently linking millions of hospitalized smokers with effective outpatient treatment—smokers that might otherwise be lost in the transition to outpatient care. Clinical Trials Registration NCT01305928