View
654
Download
0
Embed Size (px)
Citation preview
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!
• 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