The Optimizing Lung Screening Trial (WF-20817CD): Multicenter Randomized Effectiveness Implementation Trial to Increase Tobacco Use Cessation for Individuals Undergoing Lung Screening.
The Optimizing Lung Screening Trial (WF-20817CD): Multicenter Randomized Effectiveness Implementation Trial to Increase Tobacco Use Cessation for Individuals Undergoing Lung Screening.
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目前，接受肺癌筛查（LCS）的所有人中有一半使用烟草。然而，很少有已发表的研究探讨了如何在LCS遭遇期间最佳地实施有效的烟草使用治疗。优化肺部筛查干预（OaSiS）是否能有效减少社区放射机构接受LCS的患者的烟草使用？OaSiS研究（国家癌症研究所[NCI]方案编号：WF-20817 CD）是与维克森林国家癌症研究所社区肿瘤研究计划研究基地合作进行的放射学设施的有效性-实施混合II型群集随机试验。我们将20个州的26家放射科机构随机分配到干预组或常规护理组。干预机构的工作人员针对诊所和护理团队实施了各种战略。符合条件的患者参与者年龄在55至77岁之间，接受LCS，目前正在使用烟草。在LCS预约前完成基线调查的1，094人中（干预组523人，对照组471人），956人完成了6个月随访（86%留存率）。在6个月内没有使用烟草的人中，有54%通过邮寄的可替宁检测完成了生化验证。广义估计方程边际模型被用于意向治疗分析，以预测7天的烟草使用戒烟。参与者自我报告的平均禁欲率在不同设施之间差异很大（0%-27%）。尽管随着时间的推移，平均戒烟率显著增加（基线时为0%，6个月时约为13%; P < .0001），14天时烟草使用在试验组之间没有差异（OR，0.96; 95% CI，0.46-1.99; P = .90）、3个月（OR，1.17; 95% CI，0.69-1.99; P = .56）或6个月（OR，0.97; 95% CI，0.65-1.43; P = .87）。OaSiS试验参与者显示，随着时间的推移，烟草使用显著减少，但没有发现试验组之间的差异。ClinicalTrials.gov NCT03291587; URL：www.clinicaltrials.gov
One-half of all people who undergo lung cancer screening (LCS) currently use tobacco. However, few published studies have explored how to implement effective tobacco use treatment optimally during the LCS encounter. Was the Optimizing Lung Screening intervention (OaSiS) effective at reducing tobacco use among patients undergoing LCS in community-based radiology facilities? The OaSiS study (National Cancer Institute [NCI] Protocol No.: WF-20817CD) is an effectiveness-implementation hybrid type II cluster randomized trial of radiology facilities conducted in partnership with the Wake Forest National Cancer Institute Community Oncology Research Program research base. We randomly assigned 26 radiology facilities in 20 states to the intervention or usual care group. Staff at intervention facilities implemented a variety of strategies targeting the clinic and care team. Eligible patient participants were aged 55 to 77 years undergoing LCS and currently using tobacco. Of 1,094 who completed a baseline survey (523 intervention group, 471 control group) immediately before the LCS appointment, 956 completed the 6-month follow-up (86% retention rate). Fifty-four percent of those who reported not using tobacco at 6 months completed biochemical verification via mailed cotinine assay. Generalized estimating equation marginal models were used in an intention-to-treat analysis to predict 7-day tobacco use abstinence. The average self-reported abstinence among participants varied considerably across facilities (0%-27%). Despite a significant increase in average cessation rate over time (0% at baseline to approximately 13% at 6 months; P < .0001), tobacco use did not differ by trial group at 14 days (OR, 0.96; 95% CI, 0.46-1.99; P = .90), 3 months (OR, 1.17; 95% CI, 0.69-1.99; P = .56), or 6 months (OR, 0.97; 95% CI, 0.65-1.43; P = .87). The OaSiS trial participants showed a significant reduction in tobacco use over time, but no difference by trial arm was found. ClinicalTrials.gov; No.: NCT03291587; URL: www.clinicaltrials.gov