title: Smoking cessation and care management for veterans with posttraumatic stress disorder: a study protocol for a randomized controlled trial.
abstract: BACKGROUND
  Smoking remains the leading cause of preventable illness and mortality in the United States. Individuals with Posttraumatic Stress Disorder (PTSD) have smoking rates higher than that of others and fewer individuals with PTSD have quit smoking. This randomized controlled trial was designed to test the effectiveness of integrating telehealth care management and smoking cessation with motivational interviewing for Veterans with PTSD.
  
  
  METHODS
  All smokers with PTSD, regardless of their desire to quit, were invited to participate. Enrollment occurred between November 2009 and April 2013. Target enrollment was 120 participants. Enrolled participants were randomized to either the control group, receiving usual care including a telehealth PTSD program, with a device that delivered PTSD information and in-home care management, or the intervention group, which included (1) a telehealth PTSD program, (2) motivational interviewing-based smoking cessation curricula via the telehealth device, and (3) weekly motivational interviewing counseling phone calls. Outcomes are self-reported 24-hour quit attempts, progression along the stages of change and 7-day point prevalence quit smoking rates for the intervention group compared to usual care alone. Secondary outcomes include participants' perception of care coordination, patient satisfaction with motivational interviewing, PTSD symptoms, pain, depression and quality of life.
  
  
  CONCLUSIONS
  Motivational interviewing has been shown to increase readiness for change and smoking cessation care has been shown to be more successful when incorporated into in-person mental health care. Our study builds on previous studies. It integrates a written smoking cessation curriculum and phone-based motivational interviewing counseling into an established PTSD home telehealth care coordination program. This paper describes the design and methods of our randomized control trial.
  
  
  BACKGROUND
  ClinicalTrials.gov, NCT00908882, May 22, 2009.
authors: Department of Veterans Affairs, Eastern Colorado Health Care System, Denver, CO, USA. jamie.peterson@va.gov.
authors: Jamie
authors: J
authors: Peterson
authors: Department of Veterans Affairs, Eastern Colorado Health Care System, Denver, CO, USA. allan.prochazka@va.gov.|University of Colorado, Aurora, CO, USA. allan.prochazka@va.gov.
authors: Allan V
authors: AV
authors: Prochazka
authors: Department of Veterans Affairs, Eastern Colorado Health Care System, Denver, CO, USA. catherine.battaglia@va.gov.|University of Colorado, Aurora, CO, USA. catherine.battaglia@va.gov.
authors: Catherine
authors: C
authors: Battaglia
mesh_terms: D000328:Adult; D003376:Counseling / Q000379:methods; D003863:Depression / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D062405:Motivational Interviewing / Q000379:methods; D017060:Patient Satisfaction; D011788:Quality of Life; D012648:Self Care / Q000379:methods*; D016540:Smoking Cessation / Q000523:psychology*; D013313:Stress Disorders, Post-Traumatic / Q000628:therapy*; D017216:Telemedicine / Q000379:methods*; D014029:Tobacco Use Disorder / Q000523:psychology*; D014481:United States; D014728:Veterans / Q000523:psychology*
references: Anesth Analg. 2008 Mar;106(3):805-9, table of contents
references: 18292422
references: Telemed J E Health. 2008 Dec;14(10):1118-26
references: 19119835
references: Cochrane Database Syst Rev. 2010;(1):CD006936
references: 20091612
references: JAMA. 2010 Dec 8;304(22):2485-93
references: 21139110
references: Dialogues Clin Neurosci. 2011;13(3):263-78
references: 22034143
references: Am J Manag Care. 2012 Feb;18(2):77-84
references: 22435835
references: Psychol Addict Behav. 2013 Mar;27(1):249-55
references: 22642854
references: J Am Psychiatr Nurses Assoc. 2013 Mar-Apr;19(2):78-91
references: 23644675
references: JAMA. 2000 Nov 22-29;284(20):2606-10
references: 11086367
references: Nicotine Tob Res. 2002 May;4(2):149-59
references: 12028847
references: JAMA. 2002 Oct 9;288(14):1775-9
references: 12365965
references: JAMA. 2004 Mar 10;291(10):1238-45
references: 15010446
references: Pain. 1975 Sep;1(3):277-99
references: 1235985
references: J Behav Med. 1989 Apr;12(2):159-82
references: 2668531
references: J Consult Clin Psychol. 1991 Apr;59(2):295-304
references: 2030191
references: Addict Behav. 1995 Mar-Apr;20(2):189-203
references: 7484313
references: Prev Med. 1995 Jul;24(4):401-11
references: 7479632
references: Arch Gen Psychiatry. 1995 Dec;52(12):1048-60
references: 7492257
references: Med Care. 1996 Mar;34(3):220-33
references: 8628042
references: J Clin Psychol. 1996 Jul;52(4):443-7
references: 8842881
references: Ann Intern Med. 1998 Oct 15;129(8):605-12
references: 9786807
references: Eff Clin Pract. 1998 Aug-Sep;1(1):2-4
references: 10345255
references: Br J Cancer. 2005 Feb 14;92(3):426-9
references: 15668706
references: Am J Med Qual. 2005 Jan-Feb;20(1):33-9
references: 15782753
references: Telemed J E Health. 2005 Feb;11(1):20-7
references: 15785217
references: Med Care. 2005 May;43(5):436-44
references: 15838407
references: Diabetes Care. 2005 Nov;28(11):2655-61
references: 16249535
references: Lippincotts Case Manag. 2000 Sep-Oct;5(5):191-8
references: 16398033
references: Addict Behav. 2006 Feb;31(2):223-31
references: 15919158
references: Nicotine Tob Res. 2007 Nov;9(11):1071-84
references: 17978982