Blended Smoking Cessation Treatment: Exploring Measurement, Levels, and Predictors of Adherence
| Autor: | Marcel E. Pieterse, Lutz Siemer, Marjolein Brusse-Keizer, Somaya Ben Allouch, Angelos Patrinopoulos Bougioukas, Robbert Sanderman, Marloes G. Postel |
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| Přispěvatelé: | Clinical Psychology and Experimental Psychopathology, Psychology, Health & Technology |
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Male
blended treatment PROTOCOL medicine.medical_specialty 020205 medical informatics medicine.medical_treatment media_common.quotation_subject Health Informatics 02 engineering and technology tobacco smoking Odds law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial prevention law Internal medicine SUPPORT 0202 electrical engineering electronic engineering information engineering medicine Humans DEPRESSION TREATMENT 030212 general & internal medicine adherence Trial registration COGNITIVE-BEHAVIORAL THERAPY METAANALYSIS media_common Internet Original Paper business.industry Odds ratio Abstinence RANDOMIZED CONTROLLED-TRIAL ABSTINENCE EFFICACY cognitive behavioral therapy Cognitive behavioral therapy predictors Smoking cessation Marital status Female Smoking Cessation MENTAL-HEALTH-CARE business SMOKERS |
| Zdroj: | Journal of Medical Internet Research, 20(8):246. JMIR PUBLICATIONS, INC Journal of medical internet research, 20(8):e246. JMIR Publications Journal of Medical Internet Research |
| ISSN: | 1438-8871 1439-4456 |
| Popis: | Background: Blended face-to-face and Web-based treatment is a promising way to deliver cognitive behavioral therapy. Since adherence has been shown to be a measure for treatment’s acceptability and a determinant for treatment’s effectiveness, in this study, we explored adherence to a new blended smoking cessation treatment (BSCT). Objective: The objective of our study was to (1) develop an adequate method to measure adherence to BSCT; (2) define an adequate degree of adherence to be used as a threshold for being adherent; (3) estimate adherence to BSCT; and (4) explore the possible predictors of adherence to BSCT. Methods: The data of patients (N=75) were analyzed to trace adherence to BSCT delivered at an outpatient smoking cessation clinic. In total, 18 patient activities (eg, using a Web-based smoking diary tool or responding to counselors’ messages) were selected to measure adherence; the degree of adherence per patient was compared with quitting success. The minimum degree of adherence of patients who reported abstinence was examined to define a threshold for the detection of adherent patients. The number of adherent patients was calculated for each of the 18 selected activities; the degree of adherence over the course of the treatment was displayed; and the number of patients who were adherent was analyzed. The relationship between adherence and 33 person-, smoking-, and health-related characteristics was examined. Results: The method for measuring adherence was found to be adequate as adherence to BSCT correlated with self-reported abstinence (P=.03). Patients reporting abstinence adhered to at least 61% of BSCT. Adherence declined over the course of the treatment; the percentage of adherent patients per treatment activity ranged from 82% at the start of the treatment to 11%-19% at the final-third of BSCT; applying a 61% threshold, 18% of the patients were classified as adherent. Marital status and social modeling were the best independent predictors of adherence. Patients having a partner had 11-times higher odds of being adherent (OR [odds ratio]=11.3; CI: 1.33-98.99; P=.03). For social modeling, graded from 0 (=partner and friends are not smoking) to 8 (=both partner and nearly all friends are smoking), each unit increase was associated with 28% lower odds of being adherent (OR=0.72; CI: 0.55-0.94; P=.02). Conclusions: The current study is the first to explore adherence to a blended face-to-face and Web-based treatment (BSCT) based on a substantial group of patients. It revealed a rather low adherence rate to BSCT. The method for measuring adherence to BSCT could be considered adequate because the expected dose-response relationship between adherence and quitting could be verified. Furthermore, this study revealed that marital status and social modeling were independent predictors of adherence. Trial Registration: Netherlands Trial Registry NTR5113; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=5113 (Archived by WebCite at http://www.webcitation.org/71BAPwER8). |
| Databáze: | OpenAIRE |
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