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BMC Primary Care
Published in: BMC Primary Care 1/2019

Open Access 01-12-2019 | Addiction | Study protocol

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)

Authors: Sabrina Kastaun, Verena Leve, Jaqueline Hildebrandt, Christian Funke, Stephanie Becker, Diana Lubisch, Wolfgang Viechtbauer, Olaf Reddemann, Linn Hempel, Hayden McRobbie, Tobias Raupach, Robert West, Daniel Kotz

Published in: BMC Primary Care | Issue 1/2019

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Abstract

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 proposed.

Trial registration

German Clinical Trials Register (DRKS00012786); registered on 22th August 2017, prior to the first patient in.
Appendix
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Metadata
Title
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)
Authors
Sabrina Kastaun
Verena Leve
Jaqueline Hildebrandt
Christian Funke
Stephanie Becker
Diana Lubisch
Wolfgang Viechtbauer
Olaf Reddemann
Linn Hempel
Hayden McRobbie
Tobias Raupach
Robert West
Daniel Kotz
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Primary Care / Issue 1/2019
Electronic ISSN: 2731-4553
DOI
https://doi.org/10.1186/s12875-019-0986-8

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