This is a feasibility study of a personalised, integrated smoking cessation in the surgical pathway in patients undergoing major elective thoracic surgery when compared to usual care of standard community/hospital based NHS smoking cessation. Half the patients will receive the intervention and half the patients will receive usual care.
Smoking prior to major thoracic surgery is a major risk factor for development of postoperative complications which effect both short and long-term outcome. Despite this 1 in 5 patients continue to smoke before their operation. Project MURRAY is a trial comparing the effectiveness of personalised integrated smoking cessation delivered by trained health-care practitioners in the thoracic surgical pathway, and is a three part package of behaviour interventions and pharmacotherapy as per National Institute of Clinical Excellence (NICE)/ National Centre for Smoking Cessation Training (NCSCT) guidance which is supported by an adjunct web-based application. This is a pilot study to evaluate feasibility of a substantive trial and study processes in 5 adult thoracic centres including the trial coordinating site at the University Hospitals Birmingham NHS Foundation Trust. This is a multicentre feasibility study, with aim for equal weighting between the two arms of the integrated smoking cessation and an observation only group of usual care.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
120
Integrated smoking cessation behavioural therapy
Integrated smoking cessation pharmacotherapy including choice of combination nicotine replacement therapy, varenicline or electronic cigarettes
Integrated smoking cessation web-based application
Recruitment
To establish the number of patients who agree to participate in the intervention as a proportion of those eligible to enter the study
Time frame: 0 days from recruitment
Integration of intervention
Integration of the intervention into the clinical pathway by time from decision to operate from study recruitment
Time frame: 0 days from recruitment, 1 day or surgery
Barriers to recruitment
Descriptive reasons for non-participation from screening logs
Time frame: 0 days from recruitment
Fine tune procedures and data capture forms
To pilot data capture forms aiming for over 90% completion of important perioperative data for each patient
Time frame: 0 days from recruitment, 1 day of surgery, 1 month after surgery
Smoking cessation in the intervention group
To assess the proportion of patients who receive the intervention who have quit smoking
Time frame: 1 day of surgery, 1 month after surgery
Smoking cessation in the usual care group
To assess the proportion of patients in an observation only usual care group who have quit smoking
Time frame: 1 day of surgery, 1 month after surgery
Variability of smoking cessation practices
To define the variability of smoking cessation practices in all patients using the nicotine replacement usage questionnaire
Time frame: 0 days from recruitment, 1 day of surgery, 1 month after surgery
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Qualitative interview
To understand patients' experience of and engagement with the intervention, and any unintended consequences To establish whether the intervention is acceptable to thoracic surgery patients and staff, and investigate recommendations for optimisation in intervention delivery
Time frame: 1 month after surgery