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Integrated smoking cessation treatment for smokers with serious mental illness
Investigator (PI): Evins, Eden
Performing Organization (PO): (Current): Massachusetts General Hospital, Department of Psychiatry / (617) 724-5600
Supporting Agency (SA): Patient-Centered Outcomes Research Institute (PCORI)
Initial Year: 2016
Final Year: 2022
Record Source/Award ID: PCORI/PCS-1504-30472
Funding: Total Award Amount: $11,360,000
Award Type: Contract
Award Information: PCORI: More information and project results (when completed)
Abstract: Description of the problem: People with serious mental illness (SMI) in this country are those with schizophrenia, bipolar disorder, major depression, and similarly disabling conditions. Studies show that people with SMI are dying from heart disease and other smoking-related illnesses at alarming rates, with lifespans 25 years shorter than those without SMI. In addition to early death, individuals with SMI have higher rates of disabling chronic illnesses, but do not routinely receive standard medical care for them. Although overall smoking rates in the United States are 18 percent, rates among those with SMI are 53 percent. Effective treatments that double to triple abstinence rates in clinical trials in smokers with SMI are available, but not routinely offered by their primary care and psychiatric providers. The proposed intervention seeks to change that by providing targeted education to prescribers and community health worker support to both patients and prescribers to coordinate medical care for patients' cessation efforts. Importance to patients: A large-scale survey conducted at our 2014 MGH Schizophrenia Education Day indicated that smoking was among the top two primary concerns among the 250 patients, family members, and friends in attendance. The National Alliance for Mental Illness (NAMI) Hearts and Minds program is fully aligned with the goals of this project. During the design phase of this proposal, we conducted focus groups with patients and community prescribers. Patient participants clearly indicated that quitting smoking is important to them, yet they encountered difficulties with their medical providers. Prescribers revealed that although they agree the health problem is significant, they do not feel comfortable prescribing smoking cessation aids to those with SMI for reasons related to unfamiliarity with the evidence and discomfort in working with individuals with SMI. The three main outcomes we hope to achieve are an increase in the number of smokers with SMI who are abstinent at the end of the study; improved quality of life among those who get the study intervention compared to those who receive usual care; and a plan developed by our stakeholder participants to roll out the intervention and make it widely available to reduce smoking-related mortality in this important and underserved group. If successful, we anticipate that the program can be implemented in programs that typically serve these patients through use of the Affordable Care Act, state Medicaid programs, and in departments of mental health nationwide. Stakeholder partners: The proposal has been designed with extensive consultation with clinicians, scientists, patients, family members, payers, advocacy and peer stakeholders from human service agencies, community mental health centers, community health centers, government agencies, and advocacy groups. All stakeholders will contribute to the design, implementation, analysis, interpretation, and dissemination phases of the project.
MeSH Terms:
  • Health Education
  • Humans
  • Medicaid
  • Mental Disorders /complications
  • /*therapy
  • Patient Protection and Affordable Care Act
  • Program Development
  • Quality of Life
  • Schizophrenia /complications
  • /therapy
  • Smoking Cessation /*methods
  • Time Factors
  • Tobacco Use Disorder /complications
  • /*therapy
  • United States
Country: United States
State: Massachusetts
Zip Code: 02114
UI: 20162206
CTgovId: NCT02845440
Project Status: Ongoing
Record History: ('2019: Project extended to 2022\n2017: Changed Title. Previous Title: Dissemination of effective smoking cessation treatment to smokers with serious mental illness',)