Randomized Trial of a Smoking Cessation Program for Persons with SMI

SMI 患者戒烟计划的随机试验

• 批准号: 8195952
• 负责人: LISA B. DIXON
• 金额: --
• 依托单位: BALTIMORE VA MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-10-01 至 2013-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8195952
• 关键词: Abstinence; Address; Aftercare; American Lung Association; Attention; Behavior Therapy; Behavioral; Biological; Bupropion; Carbon Monoxide; Categories; Cessation of life; Characteristics; Cigarette; Clinic; Clinical Practice Guideline; Cocaine; Cognitive; Communities; Department of Defense; Diabetes Mellitus; Diagnostic; Disabled Persons; Disease; Drug usage; Education; Effectiveness; Ensure; Face; Funding; General Population; Goals; Grant; Guidelines; Health; Health Care Costs; Health care facility; Healthcare; Healthcare Systems; Heart Diseases; Heroin; Impairment; Intervention; Life; Malignant neoplasm of lung; Maryland; Measures; Medical Economics; Mental Health; Mental disorders; Modeling; Morbidity - disease rate; National Institute of Drug Abuse; Nicotine Dependence; Obesity; Outcome; Participant; Patient Self-Report; Patients; Persons; Pharmacotherapy; Phase; Policies; Population; Procedures; Public Health; Randomized; Randomized Clinical Trials; Readiness; Recruitment Activity; Reporting; Research; Schizophrenia; Series; Severities; Smoke; Smoker; Smoking; Smoking Cessation Intervention; Social support; Specific qualifier value; Substance Addiction; Substance Use Disorder; Substance abuse problem; Technology; Testing; Tobacco use; United States; United States Agency for Healthcare Research and Quality; Veterans; Withholding Treatment; Work; abstracting; addiction; base; cigarette smoking; contingency management; cost; design; evidence base; follow-up; handicapping condition; health care quality; improved; innovation; meetings; mortality; nicotine replacement; novel strategies; outreach; programs; psychologic; public health relevance; randomized trial; smoking cessation; social; social model; substance abuser; therapy development; tool; treatment program; trial comparing

Abstract Over 70% of people with serious and persistent mental illnesses (SPMI) smoke cigarettes. We have found that delivery of the 5 As of smoking cessation (Ask, Advise, Assess, Assist, Arrange) to persons with SPMI, a practice required by the VA, produces modest reductions in smoking and some increased use of smoking cessation aids, but does not increase abstinence. Existing "best practices" for smoking cessation in SPMI produce low short-term abstinence rates and almost no sustained abstinence. A new approach is needed that is designed for persons with SPMI and utilizes all available strategies for addiction treatment. We have developed an intervention called "Behavioral Treatment of Smoking Cessation in SPMI" (BTSCS), an innovative program that supplements pharmacotherapy and education with contingency management and a multifaceted behavioral group treatment that addresses the cognitive, motivational, and social support problems characteristic of people with SPMI. We propose to conduct a randomized trial of BTSCS compared to a manualized standard cessation program (StSST) that reflects current best practices. BTSCS was modeled after a successful program (Behavioral Treatment of Substance Abuse in SPMI) created by the study team that was designed for people with dual disorders. Hypotheses: We hypothesize that BTSCS will be more effective than StSST in producing and sustaining abstinence as measured by self report and expired CO levels. Subject Population: We will recruit 210 people with SPMI who smoke at least 10 cigarettes per day from the VA Maryland Healthcare System. We expect to randomize 178 people. Procedures: Participants in both conditions will receive brief outreach. Research assessments will be completed at baseline, 3 months (end of treatment), and 3- and 6- month follow ups. Potential Impact on Veterans' Health Care: The VA has recognized the high medical, economic, and social costs of smoking with directives to ensure that veterans are offered cessation programs. Testing an innovative smoking cessation treatment for persons with SPMI is highly significant for the VA because: (1) the rates of smoking among veterans are higher that the general population; (2) smoking rates among persons with SPMI are higher still, and; (3) there are virtually no smoking cessation treatments for veterans with SPMI that are effective in producing abstinence.

抽象的 超过70％的患有严重和持续性精神疾病（SPMI）烟雾的人 香烟。我们发现，从戒烟开始，这5种的交付（询问，建议， 评估，协助，安排）SPMI的人（VA要求的做法） 少量吸烟和戒烟辅助工具的使用量增加，但 不会增加禁欲。 SPMI中戒烟的现有“最佳实践” 产生较低的短期禁欲率，几乎没有持续的禁欲。一个新 需要为SPMI的人设计的方法，并利用所有可用的 成瘾治疗策略。我们已经开发了一种称为“行为的干预措施 在SPMI中戒烟的治疗”（BTSC），这是一个创新的计划， 通过应急管理补充药物治疗和教育 多方面的行为群体治疗，以解决认知，动机和 SPMI患者的社会支持问题。我们建议进行 BTSC随机试验与手动标准戒烟计划相比 （STSST）反映当前最佳实践。 BTSC是在成功后建模的 研究团队创建的计划（SPMI中药物滥用的行为处理） 这是为双重疾病的人设计的。 假设：我们假设BTSC比STSST更有效 和 通过自我报告和过期的CO水平来衡量的节制。 主题人群：我们将招募210名SPMI吸烟至少10人 VA马里兰州医疗保健系统每天香烟。我们希望随机化 178人。 程序：两种情况下的参与者都将获得简短的外展。研究 评估将在基线，3个月（治疗终止）以及3-和6--完成。 一个月随访。 对退伍军人的医疗保健的潜在影响：弗吉尼亚州已经认识到高医疗， 通过指令进行吸烟的经济和社会成本，以确保提供退伍军人 戒烟计划。测试针对患者的创新戒烟治疗 SPMI对VA非常重要，因为：（1）退伍军人的吸烟率 比普通人口更高； （2）SPMI患者的吸烟率是 更高，而且； （3）几乎没有对退伍军人的戒烟治疗 有效产生禁欲的SPMI。