title: An Algorithm Approach to Determining Smoking Cessation Treatment for Persons Living With HIV/AIDS: Results of a Pilot Trial.
abstract: BACKGROUND
  Smoking now represents one of the biggest modifiable risk factors for disease and mortality in people living with HIV (PLHIV). To produce significant changes in smoking rates among this population, treatments will need to be both acceptable to the larger segment of PLHIV smokers and feasible to implement in busy HIV clinics. The purpose of this study was to evaluate the feasibility and effects of a novel proactive algorithm-based intervention in an HIV/AIDS clinic.
  
  
  METHODS
  PLHIV smokers (N = 100) were proactively identified through their electronic medical records and were subsequently randomized at baseline to receive a 12-week pharmacotherapy-based algorithm treatment or treatment as usual. Participants were tracked in-person for 12 weeks. Participants provided information on smoking behaviors and associated constructs of cessation at each follow-up session.
  
  
  RESULTS
  The findings revealed that many smokers reported using prescribed medications when provided with a supply of cessation medication as determined by an algorithm. Compared with smokers receiving treatment as usual, PLHIV smokers prescribed these medications reported more quit attempts and greater reduction in smoking. Proxy measures of cessation readiness (eg, motivation, self-efficacy) also favored participants receiving algorithm treatment.
  
  
  CONCLUSIONS
  This algorithm-derived treatment produced positive changes across a number of important clinical markers associated with smoking cessation. Given these promising findings coupled with the brief nature of this treatment, the overall pattern of results suggests strong potential for dissemination into clinical settings and significant promise for further advancing clinical health outcomes in this population.
authors.affiliation: *Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL; †Division of Psychiatry, Roper St. Francis Hospital, Charleston, SC; and ‡Department of Internal Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL.
authors.forename: Karen L
authors.initials: KL
authors.lastname: Cropsey
authors.forename: Bianca F
authors.initials: BF
authors.lastname: Jardin
authors.forename: Greer A
authors.initials: GA
authors.lastname: Burkholder
authors.forename: C Brendan
authors.initials: CB
authors.lastname: Clark
authors.forename: James L
authors.initials: JL
authors.lastname: Raper
authors.forename: Michael S
authors.initials: MS
authors.lastname: Saag
mesh_terms: D000328:Adult; D000465:Algorithms; D001552:Benzazepines / Q000627:therapeutic use; D016642:Bupropion / Q000627:therapeutic use; D018765:Dopamine Uptake Inhibitors / Q000627:therapeutic use*; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018722:Nicotinic Agonists / Q000627:therapeutic use*; D010865:Pilot Projects; D011810:Quinoxalines / Q000627:therapeutic use; D012907:Smoking / Q000009:adverse effects* / Q000188:drug therapy; D016540:Smoking Cessation / Q000379:methods*; D061485:Tobacco Use Cessation Devices; D000068580:Varenicline
chemical_list: D001552:Benzazepines; D018765:Dopamine Uptake Inhibitors; D018722:Nicotinic Agonists; D011810:Quinoxalines; D016642:Bupropion; D000068580:Varenicline