Marteau, Theresa M., Munafò, Marcus R., Aveyard, Paul, Hill, Chloe, Whitwell, Sophia, Willis, Thomas A., Crockett, Rachel A., Hollands, Gareth J., Johnstone, Elaine C., Wright, Alison J., Prevost, A. Toby, Armstrong, David, Sutton, Stephen and Kinmonth, Ann Louise (2010) Trial protocol: Using genotype to tailor prescribing of nicotine replacement therapy: a randomised controlled trial assessing impact of communication upon adherence. BMC Public Health, 10:680. ISSN 1471-2458 (Print), 1471-2458 (Online) (doi:10.1186/1471-2458-10-680)

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Abstract

Background: The behavioural impact of pharmacogenomics is untested; informing smokers of genetic test results for responsiveness to smoking cessation medication may increase adherence to this medication. The objective of this trial is to estimate the impact upon adherence to nicotine replacement therapy (NRT) of informing smokers that their oral dose of NRT has been tailored to a DNA analysis. Hypotheses to be tested are as follows: I Adherence to NRT is greater among smokers informed that their oral dose of NRT is tailored to an analysis of DNA (genotype), compared to one tailored to nicotine dependence questionnaire score (phenotype). II Amongst smokers who fail to quit at six months, motivation to make another quit attempt is lower when informed that their oral dose of NRT was tailored to genotype rather than phenotype.

Methods/Design: An open label, parallel groups randomised trial in which 630 adult smokers (smoking 10 or more cigarettes daily) using National Health Service (NHS) stop smoking services in primary care are randomly allocated to one of two groups:

i. NRT oral dose tailored by DNA analysis (OPRM1 gene) (genotype), or
ii. NRT oral dose tailored by nicotine dependence questionnaire score (phenotype)

The primary outcome is proportion of prescribed NRT consumed in the first 28 days following an initial quit attempt, with the secondary outcome being motivation to make another quit attempt, amongst smokers not abstinent at six months. Other outcomes include adherence to NRT in the first seven days and biochemically validated smoking abstinence at six months. The primary outcome will be collected on 630 smokers allowing sufficient power to detect a 7.5% difference in mean proportion of NRT consumed using a two-tailed test at the 5% level of significance between groups. The proportion of all NRT consumed in the first four weeks of quitting will be compared between arms using an independent samples t-test and by estimating the 95% confidence interval for observed between-arm difference in mean NRT consumption (Hypothesis I). Motivation to make another quit attempt will be compared between arms in those failing to quit by six months (Hypothesis II).

Discussion: This is the first clinical trial evaluating the behavioural impact on adherence of prescribing medication using genetic rather than phenotypic information. Specific issues regarding the choice of design for trials of interventions of this kind are discussed.

Trial details: Funder: Medical Research Council (MRC)

Item Type:	Article
Additional Information:	[1] Cite this article as: Marteau et al.: Trial Protocol: Using genotype to tailor prescribing of nicotine replacement therapy: a randomised controlled trial assessing impact of communication upon adherence. BMC Public Health 2010 10:680. doi:10.1186/1471-2458-10-680. [2] Copyright: © 2010 Marteau et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Uncontrolled Keywords:	nicotine replacement therapy, trial
Subjects:	B Philosophy. Psychology. Religion > BF Psychology
Pre-2014 Departments:	School of Health & Social Care > Department of Social Work & Health Development
Related URLs:	Publisher Organisation
Last Modified:	18 Nov 2016 14:51
URI:	http://gala.gre.ac.uk/id/eprint/10281

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