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Trial registered on ANZCTR
Registration number
ACTRN12614000759695
Ethics application status
Approved
Date submitted
8/07/2014
Date registered
17/07/2014
Date last updated
1/08/2018
Type of registration
Prospectively registered
Titles & IDs
Public title
Feasibility and efficacy of tobacco treatment interventions for smokers with a history of homelessness.
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Scientific title
In smokers with a history of homelessness, does the provision of tobacco treatment interventions enhance access, treatment retention and cessation, if delivered within a residential community setting compared to an outpatient hospital setting.
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Secondary ID [1]
284938
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"Nil"
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Smoking cessation
292419
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Condition category
Condition code
Mental Health
292734
292734
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0
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Addiction
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Once informed consent is obtained and smoking status is confirmed by CO measurement using a PICO+ Bedfont Smokerlyzer (CO <5ppm indicates a non-smoker), participants will be enrolled on the 12 week treatment trial (with nicotine replacement therapy administration) with 3 monthly follow-up for 9 months. The trial stages are as follows:
1. Participants will attend an initial tobacco assessment at Common Ground with a tobacco treatment counsellor who will administer a number of research questionnaires.
2. Participants will return the following week for the first of 12 x ½ hour, weekly, counselling sessions at Common Ground, with the study counsellor, at which time nicotine replacement therapy (NRT) will be dispensed and motivational intervewing commenced. Participants will commence on 21mg x 24 hour transdermal nicotine patch and/or one of the oral forms of NRT of the participant’s choice. The starting dose and type of NRT will be determined by an assessment of the patient's nicotine dependency and CO level. The dose of NRT will be titrated up to a maximum of 42mg transdermal nicotine patch in response to symptoms of withdrawal and relapse. Flexible NRT dosing will be provided according to the patient profile and clinician advice, based on the participant’s severity of dependence and previous experiences in using NRT.
3. At each weekly treatment session participants’ self-reported smoking level will be assessed and verified by CO measurement, as will NRT use, nicotine withdrawal symptoms and mental health issues. NRT will be dispensed at each weekly treatment session for 12 weeks. Motivational counselling interventions will be used throughout the treatment protocol to enhance motivation and readiness to quit smoking.
4.After 12 weeks of treatment, the provision of free NRT will cease but participants will have the option of obtaining a script for nicotine patches for a further 12 weeks if needed. The script will be provided by their medical practitioner.
5. Face-to-face follow-up interviews will be conducted at 3 monthly intervals for a period of 9 months following termination or treatment completion. Follow-up will include biochemical verification of self-reported smoking status in expired CO measurement, administration of the research questionnaires and a review of participants' medical records. Written consent will be obtained for access to participants’ medical records.
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Intervention code [1]
289768
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Treatment: Drugs
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Intervention code [2]
289769
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Behaviour
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Comparator / control treatment
Once informed consent is obtained and smoking status is confirmed by CO measurement, participants will be enrolled on the 12 week treatment trial, using motivational interviewing counselling interventions only, with 3 monthly follow-up for 9 months. The trial stages are as follows:
1. Participants will attend an initial tobacco assessment with a tobacco treatment specialist who will administer a number of research questionnaires.
2. Participants will return the following week and attend further 12 x 1/2 hour weekly motivational interviewing counselling sessions.
3. At each treatment session, participants' self-reported smoking level will be assessed and verified by CO measurement, as will nicotine withdrawal symptoms, tobacco cravings and mental health.
4. After 12 weeks, participants will cease treatment and follow-up will commence. Face-to-face follow-up interviews will be conducted at 3 monthly intervals for a period of 9 months following termination or treatment completion. Follow-up will include biochemical verification of self-reported smoking status in expired CO measurement, administration of the research questionnaires and a review of participants' medical records. Written consent will be obtained for access to participants’ medical records.
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Control group
Active
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Outcomes
Primary outcome [1]
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Self-reported smoking cessation, verified by carbon monoxide (CO) measurement. A score CO<5ppm indicates a non-smoker
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Assessment method [1]
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Timepoint [1]
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Timepoint: 3, 6 & 9 months after treatment commencement
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Primary outcome [2]
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Attendance as measured by clinic records
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Assessment method [2]
292586
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Timepoint [2]
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13 weeks after commencement
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Secondary outcome [1]
309266
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Time to relapse as measure by self-report
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Assessment method [1]
309266
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Timepoint [1]
309266
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3, 6 and 9 months after treatment commencement
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Secondary outcome [2]
309267
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Mental and physical health as measured by self-report and medical records
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Assessment method [2]
309267
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Timepoint [2]
309267
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3, 6 & 9 months after treatment commencement
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Eligibility
Key inclusion criteria
Intervention group:
* Currently smoke cigarettes (verified by CO measurement: CO >5ppm indicates a smoker)
* Assessed as nicotine dependent based on the Fagerstrom Test for Nicotine Dependence
*Interested in quitting smoking
* Current resident of Common Ground residential facility for homeless individuals
* Willing to use nicotine replacement therapy
Control group:
* Currently smoke cigarettes (verified by CO measurement: CO >5ppm indicates a smoker)
* Assessed as nicotine dependent based on the Fagerstrom Test for Nicotine Dependence
* Interested in quitting smoking
*Current patient of Royal Prince Alfred Hospital's outpatient Opioid Treatment Program
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Minimum age
18
Years
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Maximum age
65
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
* Women who are pregnant
* Young people under the age of 18 years
* People with cognitive impairment or an intellectual disability who are unable to give informed consent
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
As a small scale community-based pilot study, 30 participants will be recruited at each site
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
4/08/2014
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Actual
16/06/2015
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Date of last participant enrolment
Anticipated
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Actual
5/04/2016
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Date of last data collection
Anticipated
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Actual
18/04/2017
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Sample size
Target
60
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Accrual to date
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Final
30
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Recruitment in Australia
Recruitment state(s)
NSW
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Recruitment hospital [1]
2712
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Royal Prince Alfred Hospital - Camperdown
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Recruitment postcode(s) [1]
8421
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2050 - Missenden Road
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Funding & Sponsors
Funding source category [1]
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Government body
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Name [1]
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Sydney Local Health District
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Address [1]
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Executive Unit
Level 11, King George V Building
Royal Prince Alfred Hospital
Missenden Road
Camperdown NSW 2050
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Country [1]
289566
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Australia
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Primary sponsor type
Hospital
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Name
Royal Prince Alfred Hospital
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Address
Drug Health Services
Level 6, King George V Building
Missenden Road
Camperdown NSW 2050
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Country
Australia
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Secondary sponsor category [1]
288248
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Charities/Societies/Foundations
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Name [1]
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Common Ground
Mission Australia
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Address [1]
288248
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31 Pyrmont Bridge Road
Camperdown NSW 2050
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Country [1]
288248
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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SLHD Ethics Review Committee (RPAH Zone) (EC00113)
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Ethics committee address [1]
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Research Development Office Research Development Office RPAH Medical Centre Suite 210A, 100 Carillon Avenue NEWTOWN NSW 2042
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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19/02/2014
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Approval date [1]
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27/01/2015
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Ethics approval number [1]
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SSA/14/RPAH/79
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Summary
Brief summary
This project will explore the feasibility and treatment effectiveness of nicotine replacement therapy and motivational interventions for smokers who have a history of homelessness. It will evaluate the impact of treatment location on participation, retention and smoking cessation rates. The trial design involves a treatment period of 12 weeks, with a further 9 months follow-up. Trial patient will be broken into two groups: (1) Thirty (30) trial participants who smoke and live in a housing facility for homeless people will receive motivationally-based counselling interventions and will commence on 21mg x 24 hour transdermal nicotine patch plus one of the forms of oral nicotine replacement therapy of the participant's choice. The dose of nicotine patch will be titrated up to a maximum of 42mg in response to withdrawal and relapse. Treatment will be delivered within the residential facility. (2) Thirty (30) trial participants attending a hospital-based opioid treatment program at Royal Prince Alfred Hospital, who smoke and have a history of homelessness, will receive motivational counselling interventions to help them to stop smoking. Treatment will be delivered within this outpatient facility.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Prof Paul Haber
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Address
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Medical Director
Drug Health Services
King George V Building
Royal Prince Alfred Hospital
Missenden Road
Camperdown NSW 2050
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Country
47658
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Australia
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Phone
47658
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612 95155779
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Louise Ross
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Address
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Tobacco Treatment Unit
Drug Health Services
Croydon Community Health Centre
24 Liverpool Road
Croydon NSW 2132
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Country
47659
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Australia
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Phone
47659
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612 9378 1306
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Fax
47659
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Email
47659
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[email protected]
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Contact person for scientific queries
Name
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Paul Haber
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Address
47660
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Medical Director
Drug Health Services
King George V Building
Royal Prince Alfred Hospital
Missenden Road
Camperdown NSW 2050
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Country
47660
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Australia
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Phone
47660
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612 95155779
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Fax
47660
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Email
47660
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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