Siemer L, Brusse-Keizer MGJ, Postel MG, et al. (2018). Blended smoking cessation treatment: Exploring measurement, levels, and predictors of adherence. Journal of Medical Internet Research. 20(8): e246. doi: 10.2196/jmir.9969
Researchers explored adherence to smoking cessation treatment among participants in a randomized controlled study (n=75) that received 5 sessions each of web-based and face-to-face treatment. Participants were recruited from a Dutch hospital after referral to outpatient smoking cessation treatment. Researchers sought to develop an objective metric of adherence that correlates with smoking cessation, identify a threshold for adherence using levels of adherence demonstrated by abstainers, and determine participant characteristics that predict adherence. Researchers analyzed data from baseline assessments of participant characteristics, completion of face-to-face and web-based treatment components, and patient-reported smoking status from 3- and 6-month follow-up assessments. Researchers chose to use digital and face-to-face activity completion as an indicator of adherence. Activities were extracted from web-based (n=10) and face to face (n=8) components of treatment and included session-linked (n=15) and session-independent activities (n=3). Participants who reported abstinence at 6 months completed at least 61% of activities, resulting in researchers setting a threshold of adherence of 61% activity completion. Participants reporting abstinence at 6 months completed significantly more activities (median: 15) than those not reporting abstinence on average (median: 9). Most participants (70%) were not adherent to either component of treatment, while 18% of participants were adherent to both components. Few participants were adherent to only one component of treatment (web-based: 5%; face-to-face: 7%). No participants completed all activities. Participants who were married and who knew fewer people who smoked were more likely to be adherent to treatment than their counterparts.