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Open Access Study protocol

Effectiveness of regular reporting of spirometric results combined with a smoking cessation advice by a primary care physician on smoking quit rate in adult smokers: a randomized controlled trial. ESPIROTAB study

Mar Rodriguez-Alvarez12*, Pere Torán-Monserrat23, Laura Muñoz-Ortiz2, Antonio Negrete-Palma23, Juan José Montero-Alia4, Mercedes Jiménez-González5, Elena Zurilla-Leonarte3, Victoria Marina-Ortega1, Montserrat Olle-Borque1, Esther Valentin-Moya1, Anna Cortada-Cabrera1, Alexis Tena-Domingo1, Silvia Martínez-González6, Victoria Vila-Palau1, Adriana Ramos-Ordoñez7, Guida Rotllant-Estelrich1, Carme Forcada-Vega8 and Eulàlia Borrell-Thió29

Author Affiliations

1 Primary Healthcare Centre Canet de Mar, Catalan Health Institute. Plaça Universitat 1, 08640 Canet de Mar (Barcelona), Spain

2 Primary Healthcare Research Support Unit Metropolitana Nord, Catalan Health Institute-IDIAP Jordi Gol. Camí del Mig 36, 08303 Mataró (Barcelona), Spain

3 Primary Healthcare Centre Gatassa, Catalan Health Institute. Camí del Mig 36 (4a planta), 08303 Mataró (Barcelona), Spain

4 Primary Healthcare Centre Rocafonda-Palau, Catalan Health Institute. Ronda Pintor Rafael Estrany 24, 08304 Mataró (Barcelona), Spain

5 Primary Healthcare Centre La Riera, Catalan Health Institute. La Riera 7, 08302 Mataró (Barcelona), Spain

6 Primary Healthcare Centre LLefià, Catalan Health Institute. Carretera Antiga de València s/n, 08913 Badalona (Barcelona), Spain

7 Primary Healthcare Centre Pineda de Mar, Catalan Health Institute. Carrer de Tarragona 49, 08397 Pineda de Mar (Barcelona), Spain

8 Primary Healthcare Service Mataró-Maresme, Catalan Health Institute. Carrer Verge de Guadalupe 2, 08303 Mataró (Barcelona), Spain

9 Primary Healthcare Centre Sant Roc, Catalan Health Institute. Carrer Vélez Rubio s/n, 08913 Badalona (Barcelona), Spain

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BMC Family Practice 2011, 12:61  doi:10.1186/1471-2296-12-61

Published: 28 June 2011

Abstract

Background

Undiagnosed airflow limitation is common in the general population and is associated with impaired health and functional status. Smoking is the most important risk factor for this condition. Although primary care practitioners see most adult smokers, few currently have spirometers or regularly order spirometry tests in these patients. Brief medical advice has shown to be effective in modifying smoking habits in a large number of smokers but only a small proportion remain abstinent after one year. The aim of this study is to evaluate the effectiveness of regular reporting of spirometric results combined with a smoking cessation advice by a primary care physician on smoking quit rate in adult smokers.

Methods/design

Intervention study with a randomized two arms in 5 primary care centres. A total of 485 smokers over the age of 18 years consulting their primary care physician will be recruited.

On the selection visit all participants will undergo a spirometry, peak expiratory flow rate, test of smoking dependence, test of motivation for giving up smoking and a questionnaire on socio-demographic data. Thereafter an appointment will be made to give the participants brief structured advice to give up smoking combined with a detailed discussion on the results of the spirometry. After this, the patients will be randomised and given appointment for follow up visits at 3, 6, 12 and 24 months. Both arms will receive brief structured advice and a detailed discussion of the spirometry results at visit 0. The control group will only be given brief structured advice about giving up smoking on the follow up. Cessation of smoking will be tested with the carbon monoxide test.

Discussion

Early identification of functional pulmonary abnormalities in asymptomatic patients or in those with little respiratory symptomatology may provide "ideal educational opportunities". These opportunities may increase the success of efforts to give up smoking and may improve the opportunities of other preventive actions to minimise patient risk. Comparing adult smokers in the intervention group with those in the control group, a minimum improvement expected with respect to the rates of smoking cessation would represent a large number of avoided morbimortality.

Trial Registration

ClinicalTrials.gov: NCT01296295