Status:
COMPLETED
Improving Tobacco Treatment Rates for Outpatient Cancer Patients Who Smoke
Lead Sponsor:
Abramson Cancer Center at Penn Medicine
Collaborating Sponsors:
National Cancer Institute (NCI)
University of Pennsylvania
Conditions:
Cancer
Smoking
Eligibility:
All Genders
Phase:
NA
Brief Summary
The main purpose of this research study is to evaluate the effectiveness of "nudges" to clinicians, to patients, or to both in increasing Tobacco Use Treatment Service (TUTS) referral and engagement; ...
Detailed Description
Continued tobacco smoking negatively impacts survival among patients with cancer. Routinely delivered evidence-based tobacco use treatment (TUT) would minimize cancer-specific and all-cause mortality,...
Eligibility Criteria
Inclusion
- Inclusion Criteria:
- Clinician participants must meet the following criteria for inclusion:
- Currently in practice at an Implementation Lab site (UPHS)
- Prescribing authority in Pennsylvania (i.e., physician, nurse practitioner, physician assistant)
- Cared for at least 1 tobacco-using patient in 30 days prior to recruitment
- English-speaking (messages will be in English)
- Patient participants must be diagnosed with cancer and report current tobacco smoking (as assessed by an by any staff collecting vital signs or initially rooming the patients such as nurses, front desk staff, MAs, nursing assistants or technicians during an Index Visit). Patients are considered in the analyzable dataset after their Index Visit and after they have a clinic visit with a clinician in the study at which point a nudge may have been delivered (see steps below).
- The process by which patients become eligible for inclusion involves a 3-step algorithm employed in the EMR:
- Step 1 - All patients seeking care within the participating Abramson Cancer Center programs are screened for tobacco use status in order to ascertain relevance to the project (i.e., tobacco exposure). This screening encounter need not be a visit with a clinician who is in the cluster randomization.
- Step 2 - This step occurs at the first visit with a clinician within the cluster randomization. Note that this might be the same encounter in which screening occurs, but does not have to be. At this visit, all patients identified as current smokers are assigned a hidden (i.e., system) variable, the value of which is based on the clinician they are scheduled to meet during that visit (i.e., cluster membership).
- Step 3 - The logic is engaged at the next (third in series) visit, wherein the system variable is used to guide the intervention based on the clinician's cohort. There must be this visit to permit the delivery of the nudges (or not, if in usual care arm). The primary outcome is clinician referral for tobacco cessation through the EHR at this visit. Thus, patients eligible for this study are only those who are screened (and positive for tobacco use) and have completed the two visits in their randomly assigned cluster (clinician clusters are the unit of randomization) during the study period.
- Outcomes are assessed at the patient level.
Exclusion
Key Trial Info
Start Date :
May 18 2021
Trial Type :
INTERVENTIONAL
Allocation :
ACTUAL
End Date :
July 31 2022
Estimated Enrollment :
2146 Patients enrolled
Trial Details
Trial ID
NCT04737031
Start Date
May 18 2021
End Date
July 31 2022
Last Update
February 13 2024
Active Locations (3)
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1
Lancaster General Hospital
Lancaster, Pennsylvania, United States, 17602
2
University of Pennsylvania
Philadelphia, Pennsylvania, United States, 19104
3
Chester County Hospital
West Chester, Pennsylvania, United States, 19380