Using NRT and Quitline Services to Help Hospitalized Smokers Stay Quit

描述(由申请人提供)： 当吸烟者住院时，他们会自愿或非自愿地戒烟。然而，他们中的大多数人在出院后不久就会重新吸烟。研究表明，出院后延长后续咨询有助于防止复发。然而，医院很难对患者出院后进行延长的随访。这项拟议的研究旨在建立一种实用的模式，在这种模式下，医院将通过以下方式与国家戒烟热线合作：医院工作人员将进行床边咨询，然后将患者转至戒烟热线。Quitline咨询师将在患者出院后主动致电患者，并提供长达2个月的咨询。通过拟议的项目，我们打算建立一个实用的模型，使其适合于更广泛的传播，同时以随机设计的严格性来测试干预措施的有效性。我们计划在一项随机试验中用2×2析因设计证明两种干预措施--出院时发放尼古丁贴片和出院后不久提供积极的电话咨询--对住院吸烟者的长期戒烟率的影响。所有符合条件的患者都会接受医院工作人员的简短咨询。这是平时的护理。研究参与者被随机分配到四种情况中的一种：常规护理、尼古丁贴片后出院、电话咨询后出院或同时进行贴片和咨询后出院。它假设贴片和咨询各自具有独立的效果，并且它们的综合效果大于任何单一干预的效果。我们还打算比较干预措施的成本效益：单独贴片，单独咨询，和联合干预，与通常的护理条件。此外，拟议的研究将使我们能够检查患者的医疗诊断是否是干预效果的调节因素，以便某些诊断的患者比其他诊断的患者从干预中受益更多。 (摘要结束)

DESCRIPTION (provided by applicant): When smokers are hospitalized they quit smoking, either voluntarily or involuntarily. Most of them, however, go back to smoking soon after discharge. Research has shown that extended follow-up counseling post-discharge can help prevent relapse. However, it is difficult for hospitals to conduct extended follow up for patients after discharge. The proposed study aims to establish a practical model in which hospitals will work with a state quitline in the following manner: Hospital staff will conduct bedside counseling and then refer patients to the quitline. Quitline counselors will proactively call patients post-discharge and provide counseling up to 2 months. With the proposed project we intend to establish a practical model that lends itself to broader dissemination, while testing the effectiveness ofthe interventions with the rigor of a randomized design. We plan to demonstrate in a randomized trial the effects of two interventions, dispensing nicotine patches at discharge and providing proactive telephone counseling soon after discharge, on the long term quit rates of hospitalized smokers in a 2 x 2 factorial design. All eligible patients receive brief counseling from hospital staff. This is usual care. Study participants are randomly assigned into one ofthe four conditions: usual care, nicotine patch post discharge, telephone counseling post discharge, or both patch and counseling post discharge. It is hypothesized that the patch and counseling each has an independent effect and their combined effect is greater than that for either single intervention. We also intend to compare the cost-effectiveness ofthe interventions: patch alone, counseling alone, and combined interventions, against the usual care condition. Further, the proposed study will allow us to examine if a patient's medical diagnosis is a moderating factor for intervention effects such that patients with certain diagnoses benefit more from the interventions than patients with other diagnoses. (End of Abstract)