Alere (United Kingdom)

Point-of-collection testing (POCT) is a relatively simple and rapid testing approach that can be applied in many areas, including infectious disease, the monitoring of cholesterol and drugs of abuse testing. Since its inception in the early 1970’s and subsequent commercialisation, initially in the form of a lateral flow pregnancy test kit, POCT has become recognised for its ability to provide the end user with rapid results. Some of the early drugs of abuse testing devices demonstrated poor performance when assessed against samples from known drug users. More recently, the sensitivity and specificity of these devices have greatly improved. However, it is still important to understand the expected performance characteristics of their intended use within the field, as well as to ensure that the degree of cross-reactivity to common substances has been well characterised. Today, there are multiple POCT devices available for drugs of abuse, covering a continually expanding testing panel in several different matrices. Whilst these devices can offer a direct benefit to the end user in terms of obtaining a rapid result, the limitations of this technology must also be taken into consideration when interpreting results obtained from these devices.

ObjectiveTo test adding an interactive voice response (IVR)-supported protocol to standard quitline treatment to prevent relapse among recently quit smokers.DesignParallel randomised controlled trial with three arms: standard quitline, standard plus technology enhanced quitline with 10 risk assessments (TEQ-10), standard plus 20 TEQ assessments (TEQ-20).SettingQuit For Life (QFL) programme.Participants1785 QFL enrolees through 19 employers or health plans who were 24+ h quit.InterventionsQFL is a 5-call telephone-based cessation programme including medications and web-based support. TEQ interventions included 10 or 20 IVR-delivered relapse risk assessments over 8 weeks with automated transfer to counselling for those at risk.Main outcome measuresSelf-reported 7-day and 30-day abstinence assessed at 6-month and 12-month post-enrolment (response rates: 61% and 59%, respectively). Missing data were imputed.Results1785 were randomised (standard n=592, TEQ-10 n=602, TEQ-20 n=591). Multiple imputation-derived, intent-to-treat 30-day quit rates (95% CI) at 6 months were 59.4% (53.7% to 63.8%) for standard, 62.3% (57.7% to 66.9%) for TEQ-10, 59.4% (53.7% to 65.1%) for TEQ-20 and 30-day quit rates at 12 months were 61.2% (55.6% to 66.8%) for standard, 60.6% (56.0% to 65.2%) for TEQ-10, 54.9% (49.0% to 60.9%) for TEQ-20. There were no significant differences in quit rates. 73.3% of TEQ participants were identified as at-risk by IVR assessments; on average, participants completed 0.41 IVR-transferred counselling calls. Positive risk assessments identified participants less likely (OR=0.56, 95% CI 0.42 to 0.76) to be abstinent at 6 months.ConclusionsStandard treatment was highly effective, with 61% remaining abstinent at 12 months using multiple imputation intent-to-treat (intent-to-treat missing=smoking quit rate: 38%). TEQ assessments identified quitters at risk for relapse. However, adding IVR-transferred counselling did not yield higher quit rates. Research is needed to determine if alternative designs can improve outcomes.Trial registration numberNCT00888992.