Impact of an Intervention of Screening, Treatment Initiation and Referral to PROmote Smoking CEssation in Emergency Department Patients

Assistance Publique - Hôpitaux de Paris152 enrolled

Overview

Smoking cessation assistance is one of the major issues in prevention policies because the prevalence of smoking remains high in France. With its numerous consultations, an emergency service seems to be an interesting place for setting up and helping with weaning, despite specific working conditions. The study, which is a pilot, is interested in the feasibility and efficacy of the implementation of a STIR (Screening, Treatment Intervention and Referral) protocol, which screening, brief intervention, nicotine replacement therapy and referral to a specialist in order to help the patients in smoking cessation.

Individual randomization as soon as the patient gives his consent and meets the inclusion - non-inclusion criteria. Control group: delivery of the "tobacco-info-service" brochure titled "Why quit smoking? ", then phone call at 7 days and a month to collect tobacco consumption. Visit for 3 month. Intervention group: STIR protocol (screening, brief intervention, incentive to download the tobacco info service application, delivery of the "tobacco-info-service" brochure, initiation of a nicotine replacement therapy with nicotine patches made by a trained emergency nurse or doctor, then three consultations face-to-face or remotely with a member of the team addictionology at 7 days, 1 and 3 months. In both groups: collection of the primary endpoint during the M3 visit. For patients who did not come (regardless of the group): call for collection of the main judgment criterion Carers will be included and will sign a consent form once the eligibility criteria have been checked and consent has been signed. They will be asked to complete an adherence questionnaire (Likert scale) regarding smoking prevention in emergency departments before the start of the study and after the last patient follow-up has taken place.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

SUPPORTIVE_CARE

Masking

NONE

Enrollment

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Age \>= to 18 years old * Active smoker defined by having smoked at least 100 cigarettes in total in his life, associated with daily consumption or weekly * Free and informed consent signed by the patient * Patient with an understanding of the French language to participate in the intervention if necessary * Patient affiliated to a social security regimen Care giver inclusion criteria: * Age ≥ 18 years * Caregiver working in one of the 3 departments participating in the study * Signature of free and informed consent Exclusion Criteria: * Absolute vital emergency * Pregnant or breastfeeding women * Contraindication to taking nicotine * Taking nicotine by patch or gum or e-cigarette * Patient under AME (national medical insurance) * Patients under guardianship

Outcomes

Primary Outcomes

Feasibility and efficacy of a smoking cessation intervention

Composite outcome: Proportion of patients who participated in follow-up consultations at 3 months after going to the emergency room and proportion of patients weaned from smoking at three months in the intervention group, compared to the control group. A patient is said to be weaned if he / she declares having stopped smoking for 7 days 3 months after his / her visit to the emergency room

Time frame: 3 months after emergency consultation

Secondary Outcomes

proportion of patients who participated in consultations at D7 and M1

Assessment of the patient circuit

Time frame: Day 7 and 1 month after emergency consultation

description of the procedure (duration of the inclusion)

Description of the research circuit

Time frame: 4 months

number of patients who refused to participate

Description of the procedure's barriers

Time frame: 4 months

Number of doctors/paramedics involved, and of staff who performed the follow-up

Description of staff involved

Time frame: 4 months

Feasibility of measuring exhaled carbon monoxide

Proportion of patients with a carbon monoxide measurement expired

Time frame: 3 months after emergency consultation

Correlation of the measurement of exhaled carbon monoxide and declaration of withdrawal

Time frame: 3 months after emergency consultation

Effectiveness of the smoking cessation intervention

Proportion of patients weaned at 7 days and at 1 month assessed, declarative, collected by phone

Time frame: Day 7 and 1 month after emergency consultation

Number of smoked cigarettes

Number of cigarettes smoked daily at 7 days, 1 and 3 months, declarative

Time frame: Day 7, 1 month and 3 month after emergency consultation

Patients' adherence to the intervention

\- Questionnaire with Likert scale: In order to measure adherence to the intervention, 13 sentences in favor of the intervention : answers from 1. I strongly disagree to 5 . I completely agree. A higher score mean a better adherence (min: 13, max : 65). \- Proportion of patients who completed follow-up consultations at 7 days and one month

Time frame: 3 month after emergency consultation

Emergency teams' adherence to the intervention

Questionnaire with Likert scale: In order to measure adherence to the intervention, 11 sentences in favor of the intervention : answers from 1. I strongly disagree to 5 . I completely agree. A higher score mean a better adherence (min: 11, max : 55).

Time frame: 3 month after emergency consultation

Patients ' adherence to the intervention, according to demographic criteria.

Description of the population according to age, gender, socio-economic characteristics, grounds for appeal

Time frame: 3 month after emergency

Impact of an Intervention of Screening, Treatment Initiation and Referral to PROmote Smoking CEssation in Emergency Department Patients

Overview

Conditions

Interventions

Eligibility

Locations (1)

Outcomes

Primary Outcomes

Secondary Outcomes