gms | German Medical Science

51. Kongress für Allgemeinmedizin und Familienmedizin

Deutsche Gesellschaft für Allgemeinmedizin und Familienmedizin (DEGAM)

21.09. - 23.09.2017, Düsseldorf

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Can tobacco cessation support be integrated into primary tuberculosis care in South Asian clinics? Process evaluation protocol of a pragmatic randomized placebo-controlled trial in Bangladesh and Pakistan

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  • M. Böckmann - Universitätsklinikum Düsseldorf, Institut für Allgemeinmedizin, Düsseldorf, Deutschland
  • I. Nohavova - University Hospital Prague (VFN v. Praze), Prag, Tschechische Republik
  • E. Kralikova - University Hospital Prague (VFN v. Praze), Prag, Tschechische Republik
  • A. Pankova - University Hospital Prague (VFN v. Praze), Prag, Tschechische Republik
  • K. Zvolska - University Hospital Prague (VFN v. Praze), Prag, Tschechische Republik
  • O. Dogar - University of York, Department of Health Sciences, York, Vereinigtes Königreich
  • A. Sheikh - The University of Edinburgh Usher Institute of Population, Health Sciences and Informatics, Edinburgh, Vereinigtes Königreich
  • K. Siddiqi - University of York, Department of Health Sciences, York, Vereinigtes Königreich
  • D. Kotz - Universitätsklinikum Düsseldorf, Institut für Allgemeinmedizin, Düsseldorf, Deutschland

51. Kongress für Allgemeinmedizin und Familienmedizin. Düsseldorf, 21.-23.09.2017. Düsseldorf: German Medical Science GMS Publishing House; 2017. Doc17degam205

doi: 10.3205/17degam205, urn:nbn:de:0183-17degam2057

Published: September 5, 2017

© 2017 Böckmann et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Background: Tobacco use not only doubles the risk of developing tuberculosis (TB) disease but also worsens the treatment outcomes of patients who continue to smoke. To reduce the burden of lung disease in Bangladesh and Pakistan, the EU-funded TB&Tobacco hybrid effectiveness- implementation study aims to implement behavioural tobacco cessation strategies into general TB care, and to assess the effectiveness of combining low-cost smoking cessation medication cytisine with behavioural support. As delivery contexts influence acceptance and practicality, process evaluation is a useful tool to analyse mechanisms and interactions within primary care for TB patients in those countries.

Question: What are the “active ingredients” of the TB&Tobacco intervention, and how are these components implemented?

Method: Our mixed methods process evaluation combines quantitative data on patient characteristics, reach of recruitment among eligible patients, and routine trial data on dose delivered with qualitative semi-structured interviews with TB health workers and patients to assess needs and acceptability of the behavioural and pharmacological support. Behaviour intervention delivery will be audio-recorded and coded by bilingual coders using a pre-defined fidelity index. Data collection and analyses are conducted together with local researchers speaking local languages.

Results: The process evaluation is currently being implemented.

Discussion: Results will inform recommendations for possible scale-up of the intervention to reduce the burden of lung diseases in countries where both TB and tobacco use prevalence is high. Working together with experienced local teams throughout data collection and analysis strengthens insights into local contexts and implications for successful integration of tobacco cessation into TB care in Bangladesh and Pakistan.