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Implementation Science
Published in: Implementation Science 1/2017

Open Access 01-12-2017 | Study protocol

Combining alcohol interventions with tobacco addictions treatment in primary care—the COMBAT study: a pragmatic cluster randomized trial

Authors: Nadia Minian, Dolly Baliunas, Laurie Zawertailo, Aliya Noormohamed, Norman Giesbrecht, Christian S. Hendershot, Bernard Le Foll, Jürgen Rehm, Andriy Samokhvalov, Peter L. Selby

Published in: Implementation Science | Issue 1/2017

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Abstract

Background

Tobacco and alcohol use present multiplicative risk for aerodigestive cancers. Reducing alcohol consumption improves smoking cessation outcomes and reduces cancer risk. Risky alcohol consumption and smoking are often treated separately despite concurrent treatment potentially leading to better outcomes for each. However, no rapidly scalable program exists for combined interventions in primary care clinics spread across wide geographic areas. This cluster randomized trial aims to report on the effects of a novel clinical decision support system (CDSS) on intervention rates by primary care practitioners addressing risky alcohol use in a smoking cessation program.

Methods/design

We will be implementing a clinical decision support system (CDSS) in 221 primary care sites participating in the Smoking Treatment for Ontario Patients (STOP) program across Ontario, Canada. Sites will be blindly allocated to one of two clinical decision support systems guiding practitioners to provide a risky alcohol use intervention to smokers attempting to quit using nicotine replacement therapy (NRT). Risky alcohol use is defined as drinking above the Canadian Cancer Society’s low-risk drinking guidelines. Primary analysis will measure the proportion of risky drinkers offered an alcohol intervention in each CDSS arm at baseline. Patients will be contacted by phone or email to track smoking cessation and alcohol consumption rates at 6- and 12-month follow-up.

Discussion

Upon completion of the trial, the effect of different clinical decision support systems on practitioner behaviour, and on client tobacco and alcohol use, will be discussed. If the CDSS successfully promotes SBIRT for risky alcohol use in a primary care setting and/or improves patient-level outcomes, including smoking cessation rates and alcohol use reduction, this tool can be used as a model for other web-based behaviour change interventions integrated into primary care practice.

Trial registration

ClinicalTrials.gov NCT03108144
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Metadata
Title
Combining alcohol interventions with tobacco addictions treatment in primary care—the COMBAT study: a pragmatic cluster randomized trial
Authors
Nadia Minian
Dolly Baliunas
Laurie Zawertailo
Aliya Noormohamed
Norman Giesbrecht
Christian S. Hendershot
Bernard Le Foll
Jürgen Rehm
Andriy Samokhvalov
Peter L. Selby
Publication date
01-12-2017
Publisher
BioMed Central
Published in
Implementation Science / Issue 1/2017
Electronic ISSN: 1748-5908
DOI
https://doi.org/10.1186/s13012-017-0595-7

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