The iQuit in Practice study evaluates a web-based computer program which provides individualised self-help smoking cessation support within general practices. The program is designed to be used alongside routine smoking cessation support provided by general practice nurses and healthcare assistants. Once enrolled smokers were randomly assigned to receive either usual care only or usual care plus iQuit support. For those receiving iQuit support, thesmoking cessation advisor enters some details about the patients smoking habits and beliefs, the program then generates an individually tailored advice report for the smoker. It also sends tailored text messages to the smoker’s mobile phone over a period of three months to support their quit attempt.
The study planned to begin recruiting in December 2009 but the first patient wasn’t recruited until March 2010 – much longer than had been anticipated. This proved to be the flavour of things to come as Felix Naughton, Research Associate and Health Psychologist, explains:
“We were quite slow to identify suitable practices at the outset, which meant that recruitment fell behind from the start. Closure was planned for March 2011 so essentially that gave us a 12 month window, but a further four months down the line we had still only recruited 33 patients of our 600 target. We realised we needed to overhaul our approach to recruitment and training. A big part of our ‘plan B’ was to ask the Primary Care Research Network for their support.”
While the Network had provided input into recruitment strategies at the outset and had been involved in advertising the study to practices in 2009, by September 2010 they were asked to work on identifying and approaching practices on behalf of the study team. However, the iQuit team were still anxious about reaching the study target:
“By our study steering group meeting in November 2010 we had only recruited 85 patients,” says Felix. “So we decided to extend the recruitment window until November 2011. But it was also about this time that the work of the Primary Care Research Network began to come to fruition.”
A massive push by the Network helped the iQuit in Practice team double the number of participating practices; of the 32 taking part, the Network engaged 14 but, in a much shorter period of time. Felix continues:
“Previously we had been selecting practices based on suitability indicators, such as size, demographics, and deprivation levels in the area, but Network staff convinced us to trust their judgment and let them get on with it. Once they had identified a practice we did the site initiation visit together, then our study team concentrated on training the practice staff, whist the Network offered recruitment support by sharing best practice across participating sites. This mutual support approach really got things moving.”
The study eventually closed in November 2011 having recruited 602 patients across 32 practices in the east of England. Felix reflects on the support he received:
“Network support was invaluable. Without their help it would have taken us much longer to recruit and it’s unlikely we would have reached our 600 target in the study timeframe. They worked tirelessly and were a pleasure to work with; friendly, highly competent, and skilled negotiators.”
For more information contact crncc.pcrn@nihr.ac.uk
