mail and web based intervention to help smokers quit: tabatic study a randomized controlled trial

Mail and web based intervention to help smokers quit: TABATIC study

Laura Díaz Gete, Carlos Martin Cantera, ElisaPuigdomenech, Jessica Sanchez Fondevila

A randomized controlled trial

Barcelona, 22 September 2015

OBJECTIVES

To evaluate the effectiveness of an intervention consisting in 2 face-to-face visits with E-mail follow-up based on the recommendations of Clinical Practice guides compared to the brief advice at 6 and 12 months post intervention in terms of:

Continuous abstinence

Reduction of tobacco consumption

Changes in the state of change according to Prochaska and Di Clemente

Reduction of sanitary resources and time (for both health professionals and patients)

FLOW CHART

Smokers (of at least one cigarette per day)

Age: 18-75 y.o.

Electronic mail account and check it regularly (at

least once a week)

WEB PAGE

WEB PAGE: HEALTH PROFESSIONAL

Dear sir/madam xxxxxxxx

According to the visit done on xx/xx/xx (date of first visit) you fixed your quitting date on: xx/xx/xx . Seven days have passed, so I would like you to answer the following questions regarding tobacco consumption:

Have you successfully quit smoking? (Yes/No)

If yes, have you experienced difficulties to quit smoking? (Yes/No)

Please, rate from 1 to 5 the difficulties (being 1 no difficult and 5 very difficult) you have experienced on the quitting smoking process: (numeric field)

If you are currently smoking, how many cigarettes per day do you smoke? (open numeric space)

If you are taking medicine to stop smoking, do you have any problems with it? (Yes/No)

Please do not hesitate to ask any questions through this internal messaging (open field).Shortly you will receive my notes/comments.Thank you.

Xxxxxxxx (name of the doctor or nurse)

Example of an E-mail of the TABATIC study intervention

Sociodemographic and tobacco consumption characteristics of study participants

RESULTS

1056 Included patients

3 month follow-up

6 month follow-up

12 month follow-up

567 (53.7% of 1056) follow-up achieved

489 no follow-up achieved

466 (44.6% of 1056) were not localized

23 did not want to continue in the study

716 (67.8% of 1056) follow-up achieved

340 (32.2% of 1056) no follow-up achieved(no response or did not want to continue in the study)

817 (77.4% of 1056) follow-up achieved

239 (22.6% of 1056) no follow-up achieved(no response or did not want to continue in the study)

FOLLOW-UP AND ATTRITION

SCIENTIFIC PRODUCTION OF TABATIC STUDY

SCIENTIFIC PRODUCTION OF TABATIC STUDY

Cross sectional study

1725 (18-85 y.o.) smokers attended in PC

Use of E-mail, SMS and web pages >65%

Young age and more educatedindividuals are the best target for ICTinterventions for smoking cessation

SCIENTIFIC PRODUCTION OF TABATIC STUDY

Qualitative study to assess patients and health care professionals on ICT

7 individual interviews and 4 focalgroups

Both patients and health professionalsviewed E-mail based interventions ashelpful but only complementary to face-to-face interventions

DISCUSSION

• Strenghts:

– Intervention based on E-mail send by patient’s reference health

professional

– Possibility to answer doubts in a tailored way

– 12 months follow-up

– Randomized inclusion

– Elevated number of participants and health professionals

• Limitations:

– No feasibility nor usability assessment of the web previous to the RCT

– Elevated number of follow-up loss mainly at three months post

intervention (face-to-face visit)

– We have experienced difficulties in the statistical analysis since the

register system is not habitual and is done by an external company

Mail and web based intervention to help smokers quit: TABATIC study

THANK YOU FOR YOUR KIND ATTENTION!

p.tabatic@gmail.com

• Is the project interesting to be published in Tobacco Control?

Is there any more suitable journal?

• Any suggestions to improve the intervention or to improve

the methodology used?

• If it is effective, we would like to be used by primary care

health professionals (for instance by integrating it in the

clinical history)

DISCUSSION

Características sociodemográficas y de consumo de tabaco de los partipantes en el estudio (1058)

Resultados basales

Nota: Un mismo paciente puede presentar una o más patologías

Características sociodemográficas y de consumo de tabaco de los partipantes en el estudio

Resultados basales

Características sociodemográficas y de consumo de tabaco de los partipantes en el estudio

Resultados basales

WEB: MENU DE NAVEGACIÓN DE INVESTIGADOR

WEB: MENSAJES INVESTIGADOR

WEB: CUENTA INVESTIGADOR

WEB: TRASPASAR PACIENTE INVESTIGADOR

WEB: MATERIAL DEL PROYECTO PARA INVESTIGADOR I

WEB: MATERIAL DEL PROYECTO PARA INVESTIGADOR II

WEB: PREGUNTAS FRECUENTES INVESTIGADOR

DIAGRAMA DE FLUJO INVESTIGADORES

� Ayuda FIS (ISCII): 2011-2014

� Ensayo clínico Estudio TABATIC

� 2 Ayudas XB (ayudas ICS, Barcelona Ciudad)

� Estudio cualitativo (2011): Intervención en personas fumadoras mediante nuevas tecnologías de comunicación: ¿Qué percepción tienen los pacientes y los profesionales sanitarios?

� Ensayo clínico (2012): Efectividad de una intervención por correo electrónico en el abandono sostenido del consumo de tabaco. Estudio TABATIC. Un ensayo clínicomulticentrico aleatorizado controlado.

AYUDAS RECIBIDAS