Randomized Controlled Trial

. 2017 Sep;32(9):1005-1013.

doi: 10.1007/s11606-017-4085-z. Epub 2017 Jun 14.

Interactive Voice Response Calls to Promote Smoking Cessation after Hospital Discharge: Pooled Analysis of Two Randomized Clinical Trials

Nancy A Rigotti^{1

2

3

4}, Yuchiao Chang^{5

6}, Lisa C Rosenfeld^{7

8}, Sandra J Japuntich^{9

10}, Elyse R Park^{11

12

7

8}, Hilary A Tindle¹³, Douglas E Levy^{11

12

6}, Zachary Z Reid¹¹, Joanna Streck¹⁴, Timothy Gomperts¹¹, Jennifer H K Kelley^{11

12}, Daniel E Singer^{5

6

15}

Affiliations

¹ Tobacco Research and Treatment Center, Massachusetts General Hospital, 50 Staniford St., Room #914, Boston, MA, 02114, USA. nrigotti@partners.org.
² Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, 50 Staniford St., Room #914, Boston, MA, 02114, USA. nrigotti@partners.org.
³ Mongan Institute for Health Policy, Massachusetts General Hospital, Boston, MA, USA. nrigotti@partners.org.
⁴ Department of Medicine, Harvard Medical School, Boston, MA, USA. nrigotti@partners.org.
⁵ Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, 50 Staniford St., Room #914, Boston, MA, 02114, USA.
⁶ Department of Medicine, Harvard Medical School, Boston, MA, USA.
⁷ Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.
⁸ McLean Hospital, Providence, RI, USA.
⁹ Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA.
¹⁰ Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA.
¹¹ Tobacco Research and Treatment Center, Massachusetts General Hospital, 50 Staniford St., Room #914, Boston, MA, 02114, USA.
¹² Mongan Institute for Health Policy, Massachusetts General Hospital, Boston, MA, USA.
¹³ Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN, USA.
¹⁴ Department of Psychological Science, University of Vermont, Burlington, VT, USA.
¹⁵ Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.

PMID: 28616847
PMCID: PMC5570745
DOI: 10.1007/s11606-017-4085-z

Randomized Controlled Trial

Interactive Voice Response Calls to Promote Smoking Cessation after Hospital Discharge: Pooled Analysis of Two Randomized Clinical Trials

Nancy A Rigotti et al. J Gen Intern Med. 2017 Sep.

. 2017 Sep;32(9):1005-1013.

doi: 10.1007/s11606-017-4085-z. Epub 2017 Jun 14.

Authors

Affiliations

¹ Tobacco Research and Treatment Center, Massachusetts General Hospital, 50 Staniford St., Room #914, Boston, MA, 02114, USA. nrigotti@partners.org.
² Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, 50 Staniford St., Room #914, Boston, MA, 02114, USA. nrigotti@partners.org.
³ Mongan Institute for Health Policy, Massachusetts General Hospital, Boston, MA, USA. nrigotti@partners.org.
⁴ Department of Medicine, Harvard Medical School, Boston, MA, USA. nrigotti@partners.org.
⁵ Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, 50 Staniford St., Room #914, Boston, MA, 02114, USA.
⁶ Department of Medicine, Harvard Medical School, Boston, MA, USA.
⁷ Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.
⁸ McLean Hospital, Providence, RI, USA.
⁹ Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA.
¹⁰ Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA.
¹¹ Tobacco Research and Treatment Center, Massachusetts General Hospital, 50 Staniford St., Room #914, Boston, MA, 02114, USA.
¹² Mongan Institute for Health Policy, Massachusetts General Hospital, Boston, MA, USA.
¹³ Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN, USA.
¹⁴ Department of Psychological Science, University of Vermont, Burlington, VT, USA.
¹⁵ Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.

PMID: 28616847
PMCID: PMC5570745
DOI: 10.1007/s11606-017-4085-z

Abstract

Background: Hospitalization offers smokers an opportunity to quit smoking. Starting cessation treatment in hospital is effective, but sustaining treatment after discharge is a challenge. Automated telephone calls with interactive voice response (IVR) technology could support treatment continuance after discharge.

Objective: To assess smokers' use of and satisfaction with an IVR-facilitated intervention and to test the relationship between intervention dose and smoking cessation.

Design: Analysis of pooled quantitative and qualitative data from the intervention groups of two similar randomized controlled trials with 6-month follow-up.

Participants: A total of 878 smokers admitted to three hospitals. All received cessation counseling in hospital and planned to stop smoking after discharge.

Intervention: After discharge, participants received free cessation medication and five automated IVR calls over 3 months. Calls delivered messages promoting smoking cessation and medication adherence, offered medication refills, and triaged smokers to additional telephone counseling.

Main measures: Number of IVR calls answered, patient satisfaction, biochemically validated tobacco abstinence 6 months after discharge.

Key results: Participants answered a median of three of five IVR calls; 70% rated the calls as helpful, citing the social support, access to counseling and medication, and reminders to quit as positive factors. Older smokers (OR 1.36, 95% CI 1.20-1.54 per decade) and smokers hospitalized for a smoking-related disease (OR 1.65, 95% CI 1.21-2.23) completed more calls. Smokers who completed more calls had higher quit rates at 6-month follow-up (OR 1.49, 95% CI 1.30-1.70, for each additional call) after multivariable adjustment for age, sex, education, discharge diagnosis, nicotine dependence, duration of medication use, and perceived importance of and confidence in quitting.

Conclusions: Automated IVR calls to support smoking cessation after hospital discharge were viewed favorably by patients. Higher IVR utilization was associated with higher odds of tobacco abstinence at 6-month follow-up. IVR technology offers health care systems a potentially scalable means of sustaining tobacco cessation interventions after hospital discharge.

Clinical trial registration: ClinicalTrials.gov Identifiers NCT01177176, NCT01714323.

Keywords: care transition; hospital medicine; interactive voice response; nicotine dependence; randomized controlled trial; smoking cessation.

PubMed Disclaimer

Conflict of interest statement

Dr. Rigotti has received a research grant from and been an unpaid consultant for Pfizer regarding smoking cessation. She receives royalties from UpToDate. Dr. Park has a grant from Pfizer to provide free varenicline for use in a trial funded by NCI. Dr. Singer has been a paid consultant to Pfizer on topics other than smoking cessation. All other authors declare that they do not have a conflict of interest.

Figures

**Figure 1**
Overview of interactive voice response calls.

See this image and copyright information in PMC

Comment in

Capsule Commentary on Rigotti et al., Interactive Voice Response Calls to Promote Smoking Cessation after Hospital Discharge: Pooled Analysis of Two Randomized Clinical Trials.
Schroeder SA. Schroeder SA. J Gen Intern Med. 2017 Sep;32(9):1028. doi: 10.1007/s11606-017-4088-9. J Gen Intern Med. 2017. PMID: 28634905 Free PMC article. No abstract available.

References

1. U.S. Department of Health and Human Services. The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General. Atlanta (GA): Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion (US) Office on Smoking and Health; 2014. http://www.surgeongeneral.gov/library/reports/50-years-of-progress/index.... Accessed April 28, 2017. NBK179276 [bookaccession]. - PubMed
1. Rigotti NA, Clair C, Munafo MR, Stead LF. Interventions for smoking cessation in hospitalised patients. Cochrane Database Syst Rev. 2012;5:001837. - PMC - PubMed
1. Fiore MC, Goplerud E, Schroeder SA. The Joint Commission’s new tobacco-cessation measures--will hospitals do the right thing? N Engl J Med. 2012;366(13):1172–1174. doi: 10.1056/NEJMp1115176. - DOI - PMC - PubMed
1. National Quality Forum. NQF endorses behavioral health measures. Available at: http://www.qualityforum.org/news_and_resources/Press_Releases/2014/NQF_e.... Published March 7, 2014. Updated 2014. Accessed May 8, 2017.
1. Reid RD, Pipe AL, Quinlan B, Oda J. Interactive voice response telephony to promote smoking cessation in patients with heart disease: a pilot study. Patient Educ Couns. 2007;66(3):319–326. doi: 10.1016/j.pec.2007.01.005. - DOI - PubMed

Publication types

Actions

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions

Substances

Actions

Associated data

Actions
- Search in PubMed
- Search in ClinicalTrials.gov
Actions
- Search in PubMed
- Search in ClinicalTrials.gov

Grants and funding

LinkOut - more resources

Full Text Sources
Other Literature Sources
- scite Smart Citations
Medical
- ClinicalTrials.gov
- MedlinePlus Health Information
Miscellaneous
- NCI CPTAC Assay Portal

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

Interactive Voice Response Calls to Promote Smoking Cessation after Hospital Discharge: Pooled Analysis of Two Randomized Clinical Trials

Affiliations

Interactive Voice Response Calls to Promote Smoking Cessation after Hospital Discharge: Pooled Analysis of Two Randomized Clinical Trials

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

Comment in

References

Publication types

MeSH terms

Substances

Associated data

Grants and funding

LinkOut - more resources

Full Text Sources

Other Literature Sources

Medical

Miscellaneous