Preventing Smoking Relapse After Total Joint Replacement Surgery

NYU Langone Health

Status: Completed

Conditions: Smoking; Smoking Cessation

Treatments: Drug: Nicotine Replacement Therapy (NRT); Behavioral: Standard Treatment Counseling; Behavioral: Comprehensive Relapse Prevention Intervention

Study type: Interventional

Funder types: Other

Identifiers

NCT03673228

18-00723

Details and patient eligibility

About

Hospitalization for elective knee or hip replacement surgery presents an outstanding opportunity to motivate people to quit smoking, because it provides an opportunity to encourage patients to remain smoke-free as they proactively quit to optimize their surgery outcomes. This study will conduct a comparative effectiveness trial of patients who quit smoking pre-operatively, comparing the current standard of care with a novel comprehensive relapse prevention intervention guided by Marlatt's Relapse Prevention Model.

Full description

The specific aims of this study are to evaluate the effectiveness and cost-effectiveness of the relapse prevention intervention and will: 1) compare the effectiveness of standard post-operative cessation treatment with a comprehensive relapse prevention intervention on smoking cessation outcomes; 2) conduct a comparative economic analysis to assess the value of the relapse prevention intervention for patients and the healthcare system; and 3) explore the impact of the interventions on surgical complications and readmissions.

Enrollment: 21 patients

Sex: All

Ages: 18 to 100 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

Patient Participants

• Received preoperative smoking cessation counseling through Orthopedic Surgery Quit Smoking Program
• Undergoing elective knee or hip arthroplasty surgery
• Have not smoked any cigarettes in the week prior to admission and carbon monoxide 4 ppm46,47
• Have a cell phone (for text messaging)
• Provide informed consent in English

Caregiver participants:

• Age ≥ 18 years
• Be a caregiver of the patient participant
• Provide informed consent in English

Exclusion criteria

• Patients will be excluded if they used smokeless tobacco or an electronic cigarette in the last 30 days.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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21 participants in 2 patient groups

Intervention Group

Experimental group

Description:

Participants randomized to the Intervention Arm will receive counseling that includes: * A Visit prior to discharge * Follow up calls after discharge * Text Messaging Support * Caregiver Support

Treatment:

Drug: Nicotine Replacement Therapy (NRT)

Behavioral: Comprehensive Relapse Prevention Intervention

Standard treatment

Active Comparator group

Description:

Patients will receive current usual care.

Treatment:

Drug: Nicotine Replacement Therapy (NRT)

Behavioral: Standard Treatment Counseling