A study from Northwestern Medicine investigators evaluating two new approaches to improving smoking cessation treatment for people living with HIV has received a significant boost in its clinical trial enrollment, due in large part to a dedicated clinical pharmacist working at one of the largest HIV/AIDS clinics in the U.S.
Since April 2022, the Ruth M. Rothstein CORE Center’s Blake Max, PharmD, AAHIVP, has worked closely with the study’s research team to aid in recruitment. As a result of his commitment, Dr. Max has referred over 100 candidates to the study, and 40 CORE patients have enrolled in the clinical trial with very high engagement and retention.
“For many of our patients living with HIV, the virus is well controlled, but it is the other comorbid conditions that impact our patient’s overall health, like smoking, that we need to address,” said Dr. Max. “The study offers treatment plus consultation that we thought would be an excellent opportunity for our patients to achieve their goal of smoking cessation.”
Over 10 years ago, the CORE Center conducted a smoking cessation quality assurance project and found that approximately half of the clinic population smoked cigarettes. One of the main project goals was to get patients to quit smoking by offering a cash incentive, but this was not successful. Over the last decade, Dr. Max has recognized how difficult it is for CORE Center patients to quit smoking and that inspired him to collaborate on this study.
The Northwestern HIV Treatment Optimization (HTO) clinical site is led by Third Coast CFAR members Brian Hitsman, PhD, through the Department of Preventive Medicine, and Chad Achenbach, MD, MPH, through the Department of Medicine. Two new approaches to smoking cessation treatment and their combination are being evaluated:
- Tailoring the selection of smoking cessation medication (nicotine patch therapy or varenicline) based on an individual’s rate of nicotine metabolism versus not tailoring medication (varenicline is automatically selected).
- Enhanced medication adherence counseling that is based on managed problem-solving versus standard adherence counseling.
This study is supported by a National Cancer Institute grant led by Principal Investigators Robert Schnoll, PhD, and Robert Gross, MD, MSCE at the University of Pennsylvania.
“It has been a pleasure to work with PIs at both Penn and Northwestern,” said Dr. Achenbach. “Each site has a unique perspective and different connections throughout Philadelphia and Chicago for smoking cessation and HIV clinical research. I have learned a lot from them about smoking cessation, getting our HIV population healthier, and innovative behavioral health approaches in research.”
The success of the HTO study would not be possible without the development of key collaborations and partnerships.
“Third Coast CFAR has helped us in many ways with creating connections and promoting the HTO study,” said Dr. Achenbach. “Several years ago, our submission for a Third Coast CFAR Ending the HIV Epidemic grant application with investigators at the CORE Center led to a collaboration with Blake on the HTO study. Our collaboration with Blake illustrates the importance and impact of partnerships and having dedicated people within the partnership who understand and see the benefit of getting more individuals living with HIV into clinical research that promotes healthy behaviors.”
Dr. Max recognizes the significance of his contributions to this study but knows there is still a long way to go to help more people living with HIV quit smoking.
“For me, it is a reminder that 10 years after we completed our own study, we still have a significant number of patients who continue to smoke, but who want to quit and just need the extra help or incentive to achieve that goal,” said Dr. Max. “We are very proud of our patients who have who have completed the study and for many it has been a lifelong, daily challenge to quit smoking.”