title: An interactive voice response system to continue a hospital-based smoking cessation intervention after discharge.
abstract: BACKGROUND
  Hospitalized smokers benefit from tobacco counseling received in hospital only if it continues after discharge. Interactive voice response (IVR) technology may be useful in delivering this care.
  
  
  METHODS
  We conducted a randomized controlled trial testing two intensities of follow-up contact using an IVR system; 738 cigarette smokers who received inpatient counseling at an academic medical center were enrolled. Participants were randomized to receive four IVR calls during the first month postdischarge that included the offer of a call back (CB) from a smoking counselor (IVR + CB, N = 368) or 1 IVR call at 2 weeks postdischarge that assessed smoking outcomes without offering any counseling support (IVR, N = 370). All were assessed by human telephone call at 12 weeks. Postdischarge counseling and medication utilization rates and self-reported smoking cessation were assessed at 2 and 12 weeks postdischarge.
  
  
  RESULTS
  Of those randomized to IVR + CB, 59% received a CB offer and 34% of those receiving offers accepted. Cessation rates did not differ between IVR + CB and IVR at 2 weeks (39% vs. 39%, rate ratio: 1.02, 95% CI: 0.85-1.22) or 12 weeks (29% vs. 26%, rate ratio: 1.11, 95% CI: 0.90-1.41). Medication use did not differ by group but was higher among those accepting versus declining CB offers (69% vs. 52%, p < .05).
  
  
  CONCLUSIONS
  An IVR system is feasible for postdischarge follow-up and support for hospitalized smokers. Participants, especially pharmacotherapy users, took advantage of postdischarge counseling offers, although offers were not associated with increased smoking cessation.
authors.affiliation: General Medicine Division, Massachusetts General Hospital, 50 Staniford Street, Boston, MA 02114, USA. sregan@partners.org
authors.forename: Susan
authors.initials: S
authors.lastname: Regan
authors.forename: Michele
authors.initials: M
authors.lastname: Reyen
authors.forename: Abigail C
authors.initials: AC
authors.lastname: Lockhart
authors.forename: Ann E
authors.initials: AE
authors.lastname: Richards
authors.forename: Nancy A
authors.initials: NA
authors.lastname: Rigotti
mesh_terms: D003376:Counseling / Q000379:methods; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006293:Health Promotion; D006801:Humans; D008297:Male; D008404:Massachusetts; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods*; D010351:Patient Discharge; D010353:Patient Education as Topic; D012651:Self Medication / Q000706:statistics & numerical data; D012907:Smoking / Q000523:psychology / Q000628:therapy*; D016540:Smoking Cessation / Q000379:methods / Q000523:psychology* / Q000706:statistics & numerical data; D013689:Telephone / Q000706:statistics & numerical data*; D013997:Time Factors; D014584:User-Computer Interface