Smokers with Psychiatric Diagnoses Benefitted More from 16 Weeks of Medication than Those Without Such Diagnoses
It turns out that 16 weeks of quit-smoking medications improves quit rates, compared to 8 weeks of medications, for smokers with a history of psychiatric diagnoses, but not for those without such diagnoses in a recent UW-CTRI study. Dr. Megan Piper, UW-CTRI Associate Director of Research, presented results from the UW-Partnership to Assist and Serve Smokers (UW-PASS) Study during the UW Department of Medicine (DOM) Research Day June 3 at the Health Sciences Learning Center in Madison.
In addition, when researchers gave participants just 8 weeks of medications, those without psychiatric diagnoses were twice as successful quitting as those with psychiatric diagnoses (about 35% versus 17%). However, when researchers gave both groups of participants 16 weeks of medications, it eliminated the disparity—both groups quit at the same rate (about 27%, see darker bars in Figure 1). More research is needed to understand these dynamics.
It wasn’t a surprise that those with a history of psychiatric diagnoses did better with a longer duration (16 weeks) of combination nicotine-replacement medications than shorter (8 weeks), but it was a bit of a surprise that they did better with minimal in-person counseling than intensive (see Figure 2).
UW-PASS researchers examined a sample of 637 patients (41% had 1 or more self-reported psychiatric diagnoses) at 11 primary-care clinics in the Dean Health Care and Aurora Healthcare systems. Patients who came into these clinics for primary-care visits were identified as smokers, offered the study, and referred via Epic electronic health records (EHR) to the study. Therefore, these findings directly translate to smokers in primary care settings who are trying to quit smoking.
In addition to Piper’s presentation, two UW-CTRI researchers presented posters at DOM Research Day.
UW-CTRI Researcher Dr. Kristin Berg presented her poster, "Tobacco Treatment: Identifying Disparities in Treatment Invitations." This research examined referrals to UW-CTRI’s BREATHE study among participating healthcare clinics. Healthcare clinics with higher racial diversity—as well as lower education and income level—were more likely to have disparities in referrals to BREATHE. Clinic staff were less likely to refer younger patients or patients who were neither Caucasian nor African American. Disparities existed despite BREATHE’s efforts to: recruit evenly through a standardized EHR protocol, offer clinic incentives for meeting recruitment goals, and provide free medications.
UW-CTRI Researcher Dr. Tanya Schlam presented her poster, "Identifying Intervention Components to Improve Adherence to Smoking Cessation Medication." This research tested use of a combination of nicotine patch plus nicotine gum for 8 versus 26 weeks for quitting smoking. It also explored various strategies to encourage adherence to cessation medication, including the “Helping Hand” electronic medication monitoring device for tracking use of nicotine gum combined with feedback and counseling. Among those receiving maintenance counseling, those receiving all three adherence interventions had the highest gum use (3.8 pieces per day), while those receiving no adherence interventions had the lowest gum use (2 pieces per day). Electronic medication monitoring with feedback and counseling as well as automated adherence calls increased abstinence under certain conditions. People who used more nicotine gum in the first 6 weeks were more likely to be abstinent at 6 months after the target quit day. “It does seem important to increase adherence to medication,” Dr. Schlam said.
Drs. Kristin Berg and Tanya Schlam