Testing the feasibility of the QuitAid smoking cessation intervention in a randomized factorial design in an independent, rural community pharmacy

Melissa A Little; Taylor Reid; Matthew Moncrief; Wendy Cohn; Kara P Wiseman; Candace H Wood; Wen You; Roger T Anderson; Rebecca A Krukowski

doi:10.1186/s40814-024-01465-9

Testing the feasibility of the QuitAid smoking cessation intervention in a randomized factorial design in an independent, rural community pharmacy

Pilot Feasibility Stud. 2024 Feb 26;10(1):41. doi: 10.1186/s40814-024-01465-9.

Authors

Melissa A Little^{1

2}, Taylor Reid^{3

4}, Matthew Moncrief³, Wendy Cohn^{3

4}, Kara P Wiseman^{3

4}, Candace H Wood⁵, Wen You^{3

4}, Roger T Anderson^{3

4}, Rebecca A Krukowski^{3

4}

Affiliations

¹ Department of Public Health Sciences, University of Virginia, School of Medicine, PO Box 800765, Charlottesville, VA, 22908-0765, USA. mal7uj@virginia.edu.
² Cancer Control and Population Health, University of Virginia Cancer Center, Charlottesville, VA, USA. mal7uj@virginia.edu.
³ Department of Public Health Sciences, University of Virginia, School of Medicine, PO Box 800765, Charlottesville, VA, 22908-0765, USA.
⁴ Cancer Control and Population Health, University of Virginia Cancer Center, Charlottesville, VA, USA.
⁵ My Pharmacy, 2525 A Phillips Ave, Greensboro, NC, USA.

Abstract

Background: Adult smoking rates in the USA are highest in economically depressed rural Appalachia. Pharmacist-delivered tobacco cessation support that incorporates medication therapy management (such as the QuitAid intervention) is a promising approach to address this need.

Methods: Twenty-four adult smokers recruited between September and November 2021 through an independent pharmacy in rural Appalachia were randomized in a non-blinded 2 × 2 × 2 factorial design to (1) pharmacist delivered QuitAid intervention (yes vs. no); (2) combination nicotine replacement therapy (NRT) gum + NRT patch (vs. NRT patch); and/or (3) 8 weeks of NRT (vs. standard 4 weeks). Participants received 4 weeks of NRT patch in addition to the components to which they were assigned. Participants completed baseline and 3-month follow-up assessments. Primary outcomes were feasibility of recruitment and randomization, retention, treatment adherence, and fidelity.

Results: Participants were recruited in 7 weeks primarily through a referral process, commonly referred to as ask-advise-connect (61%). Participants were on average 52.4 years old, 29.2% were male and the majority were white (91.6%) and Non-Hispanic (91.7%). There was a high level of adherence to the interventions, with 85% of QuitAid sessions completed, 83.3% of the patch used, and 54.5% of gum used. Participants reported a high level of satisfaction with the program, and there was a high level of retention (92%).

Conclusions: This demonstration pilot randomized controlled study indicates that an ask-advise-connect model for connecting rural smokers to smoking cessation support and providing QuitAid for smoking cessation is feasible and acceptable among rural Appalachian smokers and independent pharmacists. Further investigation into the efficacy of a pharmacist-delivered approach for smoking cessation is needed.

Trial registration: The trial was retrospectively registered at ClinicalTrials.gov. Trial #: NCT05649241.

Keywords: Independent pharmacy; Medication therapy management; Nicotine replacement therapy; Rural health; Smoking cessation.

Associated data

ClinicalTrials.gov/NCT05649241

Abstract

Associated data

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