Pragmatic clinical evaluation of a computerised algorithm-generating personalised treatment recommendations for smoking cessation

Pragmatic clinical evaluation of a computerised algorithm-generating personalised treatment recommendations for smoking cessation
Sian Retallick, Chief Pharmacist, Hyde Park Pharmacy, Plymouth, Devon, UK

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Abstract

Background:
Prior consideration of pharmacogenetic and biometric data to give advance indication of suitable treatment has potential to maximise effectiveness of therapy.

Methods:
We conducted a 12-month multi-centre pragmatic clinical evaluation of a novel computerised decision support programme with pharmacogenetic testing to guide NHS prescribing. Smoking status was validated by exhaled CO. Quit rates were calculated as validated quitters/[all those included + lost to follow-up].

Results:
203 smokers participated. Of these, 24(12%) did not complete exercises required to generate a personalised treatment recommendation (PTR) and 44 participants (21%) did not set a quit date. 135 participants received a PTR and 83 of these (62%) took medication in accordance with the PTR, 26 (19%) deviated from the PTR and 26 (19%) chose not to collect any medication. Median (range) age 45 (17,78) years, 39% male. Median (range) 20 (5, 40)) cigarettes per day, 25 (3, 52) years smoking with 3
(0, 15) previous quit attempts. 35/39 participants (90% [95% CI 81%, 99%]) were validated quitters at one week and 39/83 (48% [95% CI 37%, 58%]) validated at four weeks vs. 33% NHS.

Conclusions:
These results suggest that PTRs are effective and significantly enhance quit rates over those achieved with current best practice alone.

Conflict of interest:
Dr Robert Walton is Chief Scientific Officer (CSO) of g-Nostics Ltd. which has a commercial interest in NicoTest.

Dr Lisa Miles is Technical Projects Manager for g-Nostics Ltd. Wwhich has a commercial interest in NicoTest. Sian Retallick is a community-based pharmacist and has no conflict of interest
relating to this study.

Funding:
g-Nostics Ltd. was the funder of the study. This study received full UK-wide Ethics approval and local Research Governance approval from the UK National Health Service.