Adaptive Pharmacotherapy Shows Promise in Smoking Cessation: JAMA

A recent study published in the Journal of American Medical Association found that adaptive pharmacotherapy, a method of tailoring medication regimens based on patient response, significantly improves smoking cessation rates in a clinical practice setting. The study, stopped early due to the COVID-19 pandemic, compared adaptive treatment with standard treatment for smoking cessation. 

Unlike traditional approaches that provide a fixed medication regimen, adaptive treatment allows for adjustments based on the patient's response to the treatment. While previous studies have shown the efficacy of adaptive treatment using precessation nicotine patches, the use of precessation varenicline (a medication to help quit smoking) and its application in clinical practice settings remained largely unexplored.

The primary objective of this double-blinded, stratified placebo-controlled randomized clinical trial was to determine whether adaptive pharmacotherapy could achieve higher smoking abstinence rates compared to standard pharmacotherapy in a real-world clinical practice setting. 

Participants in the trial were given the choice between varenicline or nicotine patches, and they were then randomized into either the adaptive or nonadaptive (standard) treatment group. The adaptive group began their chosen medication four weeks before their target quit day. After two weeks, participants were assessed for their response to the treatment.