113 research outputs found
Effectiveness of training general practitioners to improve the implementation of brief stop-smoking advice in German primary care: study protocol of a pragmatic, 2-arm cluster randomised controlled trial (the ABCII trial)
Background: The German clinical guideline on tobacco addiction recommends that general practitioners (GPs)
provide brief stop-smoking advice to their patients according to the “5A” or the much briefer “ABC” method, but its
implementation is insufficient. A lack of training is one barrier for GPs to provide such advice. Moreover, the respective
effectiveness of a 5A or ABC training regarding subsequent delivery of stop-smoking advice has not been investigated.
We developed a training for GPs according to both methods, and conducted a pilot study with process evaluation to
optimize the trainings according to the needs of GPs. This study aims at evaluating the effectiveness of both trainings.
Methods: A pragmatic 2-arm cluster randomised controlled trial with a pre-post data collection will be conducted in
48 GP practices in North Rhine-Westphalia (Germany). GPs will be randomised to receive a 3.5-h-training in delivering
either 5A or ABC, including peer coaching and intensive role plays with professional actors. The patient-reported
primary outcome (receipt of GP advice to quit: yes/no) and secondary outcomes (recommendation rates of smoking
cessation treatments, group comparison (5A versus ABC): receipt of GP advice to quit) will be collected in smoking
patients routinely consulting their GP within 4 weeks prior, and 4 weeks following the training. Additional secondary
outcomes will be collected at 4, 12 and 26 weeks following the consultation: use of cessation treatments during the
last quit attempt (if so) since the GP consultation, and point-prevalence abstinence rates. The primary data analysis will
be conducted using a mixed-effects logistic regression model with random effects for the cluster variable.
Discussion: If the training increases the rates of delivery of stop-smoking advice, it would offer a low-threshold
strategy for the guideline implementation in German primary care. Should one method prove superior, a more specific
guideline recommendation can be propose
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