Trial Protocol: Using genotype to tailor prescribing of nicotine replacement therapy: a randomised controlled trial assessing impact of communication upon adherence.

BACKGROUND: The behavioural impact of pharmacogenomics is untested; informing smokers of genetic test results for responsiveness to smoking cessation medication may increase adherence to this medication. The objective of this trial is to estimate the impact upon adherence to nicotine replacement the...

Full description

Bibliographic Details
Main Authors: Marteau, T, Munafò, MR, Aveyard, P, Hill, C, Whitwell, S, Willis, T, Crockett, R, Hollands, G, Johnstone, E, Wright, A, Prevost, A, Armstrong, D, Sutton, S, Kinmonth, A
Format: Journal article
Language:English
Published: BioMed Central 2010
_version_ 1797098098554568704
author Marteau, T
Munafò, MR
Aveyard, P
Hill, C
Whitwell, S
Willis, T
Crockett, R
Hollands, G
Johnstone, E
Wright, A
Prevost, A
Armstrong, D
Sutton, S
Kinmonth, A
author_facet Marteau, T
Munafò, MR
Aveyard, P
Hill, C
Whitwell, S
Willis, T
Crockett, R
Hollands, G
Johnstone, E
Wright, A
Prevost, A
Armstrong, D
Sutton, S
Kinmonth, A
author_sort Marteau, T
collection OXFORD
description BACKGROUND: The behavioural impact of pharmacogenomics is untested; informing smokers of genetic test results for responsiveness to smoking cessation medication may increase adherence to this medication. The objective of this trial is to estimate the impact upon adherence to nicotine replacement therapy (NRT) of informing smokers that their oral dose of NRT has been tailored to a DNA analysis. Hypotheses to be tested are as follows: I Adherence to NRT is greater among smokers informed that their oral dose of NRT is tailored to an analysis of DNA (genotype), compared to one tailored to nicotine dependence questionnaire score (phenotype). II Amongst smokers who fail to quit at six months, motivation to make another quit attempt is lower when informed that their oral dose of NRT was tailored to genotype rather than phenotype. METHODS/DESIGN: An open label, parallel groups randomised trial in which 630 adult smokers (smoking 10 or more cigarettes daily) using National Health Service (NHS) stop smoking services in primary care are randomly allocated to one of two groups:i. NRT oral dose tailored by DNA analysis (OPRM1 gene) (genotype), orii. NRT oral dose tailored by nicotine dependence questionnaire score (phenotype)The primary outcome is proportion of prescribed NRT consumed in the first 28 days following an initial quit attempt, with the secondary outcome being motivation to make another quit attempt, amongst smokers not abstinent at six months. Other outcomes include adherence to NRT in the first seven days and biochemically validated smoking abstinence at six months. The primary outcome will be collected on 630 smokers allowing sufficient power to detect a 7.5% difference in mean proportion of NRT consumed using a two-tailed test at the 5% level of significance between groups. The proportion of all NRT consumed in the first four weeks of quitting will be compared between arms using an independent samples t-test and by estimating the 95% confidence interval for observed between-arm difference in mean NRT consumption (Hypothesis I). Motivation to make another quit attempt will be compared between arms in those failing to quit by six months (Hypothesis II). DISCUSSION: This is the first clinical trial evaluating the behavioural impact on adherence of prescribing medication using genetic rather than phenotypic information. Specific issues regarding the choice of design for trials of interventions of this kind are discussed. TRIAL DETAILS: Funder: Medical Research Council (MRC)Grant number: G0500274. ISRCTN: 14352545. Date trial stated: June 2007. Expected end date: December 2009. Expected reporting date: December 2010.
first_indexed 2024-03-07T05:04:48Z
format Journal article
id oxford-uuid:d98c613a-8e6f-4c1c-9a66-674816a4c81c
institution University of Oxford
language English
last_indexed 2024-03-07T05:04:48Z
publishDate 2010
publisher BioMed Central
record_format dspace
spelling oxford-uuid:d98c613a-8e6f-4c1c-9a66-674816a4c81c2022-03-27T08:56:43ZTrial Protocol: Using genotype to tailor prescribing of nicotine replacement therapy: a randomised controlled trial assessing impact of communication upon adherence.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:d98c613a-8e6f-4c1c-9a66-674816a4c81cEnglishSymplectic Elements at OxfordBioMed Central2010Marteau, TMunafò, MRAveyard, PHill, CWhitwell, SWillis, TCrockett, RHollands, GJohnstone, EWright, APrevost, AArmstrong, DSutton, SKinmonth, ABACKGROUND: The behavioural impact of pharmacogenomics is untested; informing smokers of genetic test results for responsiveness to smoking cessation medication may increase adherence to this medication. The objective of this trial is to estimate the impact upon adherence to nicotine replacement therapy (NRT) of informing smokers that their oral dose of NRT has been tailored to a DNA analysis. Hypotheses to be tested are as follows: I Adherence to NRT is greater among smokers informed that their oral dose of NRT is tailored to an analysis of DNA (genotype), compared to one tailored to nicotine dependence questionnaire score (phenotype). II Amongst smokers who fail to quit at six months, motivation to make another quit attempt is lower when informed that their oral dose of NRT was tailored to genotype rather than phenotype. METHODS/DESIGN: An open label, parallel groups randomised trial in which 630 adult smokers (smoking 10 or more cigarettes daily) using National Health Service (NHS) stop smoking services in primary care are randomly allocated to one of two groups:i. NRT oral dose tailored by DNA analysis (OPRM1 gene) (genotype), orii. NRT oral dose tailored by nicotine dependence questionnaire score (phenotype)The primary outcome is proportion of prescribed NRT consumed in the first 28 days following an initial quit attempt, with the secondary outcome being motivation to make another quit attempt, amongst smokers not abstinent at six months. Other outcomes include adherence to NRT in the first seven days and biochemically validated smoking abstinence at six months. The primary outcome will be collected on 630 smokers allowing sufficient power to detect a 7.5% difference in mean proportion of NRT consumed using a two-tailed test at the 5% level of significance between groups. The proportion of all NRT consumed in the first four weeks of quitting will be compared between arms using an independent samples t-test and by estimating the 95% confidence interval for observed between-arm difference in mean NRT consumption (Hypothesis I). Motivation to make another quit attempt will be compared between arms in those failing to quit by six months (Hypothesis II). DISCUSSION: This is the first clinical trial evaluating the behavioural impact on adherence of prescribing medication using genetic rather than phenotypic information. Specific issues regarding the choice of design for trials of interventions of this kind are discussed. TRIAL DETAILS: Funder: Medical Research Council (MRC)Grant number: G0500274. ISRCTN: 14352545. Date trial stated: June 2007. Expected end date: December 2009. Expected reporting date: December 2010.
spellingShingle Marteau, T
Munafò, MR
Aveyard, P
Hill, C
Whitwell, S
Willis, T
Crockett, R
Hollands, G
Johnstone, E
Wright, A
Prevost, A
Armstrong, D
Sutton, S
Kinmonth, A
Trial Protocol: Using genotype to tailor prescribing of nicotine replacement therapy: a randomised controlled trial assessing impact of communication upon adherence.
title Trial Protocol: Using genotype to tailor prescribing of nicotine replacement therapy: a randomised controlled trial assessing impact of communication upon adherence.
title_full Trial Protocol: Using genotype to tailor prescribing of nicotine replacement therapy: a randomised controlled trial assessing impact of communication upon adherence.
title_fullStr Trial Protocol: Using genotype to tailor prescribing of nicotine replacement therapy: a randomised controlled trial assessing impact of communication upon adherence.
title_full_unstemmed Trial Protocol: Using genotype to tailor prescribing of nicotine replacement therapy: a randomised controlled trial assessing impact of communication upon adherence.
title_short Trial Protocol: Using genotype to tailor prescribing of nicotine replacement therapy: a randomised controlled trial assessing impact of communication upon adherence.
title_sort trial protocol using genotype to tailor prescribing of nicotine replacement therapy a randomised controlled trial assessing impact of communication upon adherence
work_keys_str_mv AT marteaut trialprotocolusinggenotypetotailorprescribingofnicotinereplacementtherapyarandomisedcontrolledtrialassessingimpactofcommunicationuponadherence
AT munafomr trialprotocolusinggenotypetotailorprescribingofnicotinereplacementtherapyarandomisedcontrolledtrialassessingimpactofcommunicationuponadherence
AT aveyardp trialprotocolusinggenotypetotailorprescribingofnicotinereplacementtherapyarandomisedcontrolledtrialassessingimpactofcommunicationuponadherence
AT hillc trialprotocolusinggenotypetotailorprescribingofnicotinereplacementtherapyarandomisedcontrolledtrialassessingimpactofcommunicationuponadherence
AT whitwells trialprotocolusinggenotypetotailorprescribingofnicotinereplacementtherapyarandomisedcontrolledtrialassessingimpactofcommunicationuponadherence
AT willist trialprotocolusinggenotypetotailorprescribingofnicotinereplacementtherapyarandomisedcontrolledtrialassessingimpactofcommunicationuponadherence
AT crockettr trialprotocolusinggenotypetotailorprescribingofnicotinereplacementtherapyarandomisedcontrolledtrialassessingimpactofcommunicationuponadherence
AT hollandsg trialprotocolusinggenotypetotailorprescribingofnicotinereplacementtherapyarandomisedcontrolledtrialassessingimpactofcommunicationuponadherence
AT johnstonee trialprotocolusinggenotypetotailorprescribingofnicotinereplacementtherapyarandomisedcontrolledtrialassessingimpactofcommunicationuponadherence
AT wrighta trialprotocolusinggenotypetotailorprescribingofnicotinereplacementtherapyarandomisedcontrolledtrialassessingimpactofcommunicationuponadherence
AT prevosta trialprotocolusinggenotypetotailorprescribingofnicotinereplacementtherapyarandomisedcontrolledtrialassessingimpactofcommunicationuponadherence
AT armstrongd trialprotocolusinggenotypetotailorprescribingofnicotinereplacementtherapyarandomisedcontrolledtrialassessingimpactofcommunicationuponadherence
AT suttons trialprotocolusinggenotypetotailorprescribingofnicotinereplacementtherapyarandomisedcontrolledtrialassessingimpactofcommunicationuponadherence
AT kinmontha trialprotocolusinggenotypetotailorprescribingofnicotinereplacementtherapyarandomisedcontrolledtrialassessingimpactofcommunicationuponadherence