(PS2-85) Recruitment in an Episodic Future Thinking Intervention for Comorbid Tobacco Use Disorder and Bipolar Disorder

Abstract Text: People with bipolar disorder have higher rates of tobacco use and lower quit rates compared to the general population. There is value in identifying interventions that can help people with bipolar disorder who smoke cigarettes engage with smoking cessation treatment. To that end, we are conducting an open non-randomized pilot trial (N=10) to evaluate the acceptability and feasibility of Future Self-BD, an episodic future thinking intervention aimed at helping individuals with bipolar disorder enter smoking cessation treatment. The purpose of this poster is to describe study recruitment and challenges with participant attrition.

Study participants are first screened by phone and then complete a virtual screening visit that confirms their eligibility. Eligible participants are aged 18 or older, have a diagnosis of bipolar disorder, a diagnosis of tobacco use disorder, are smoking at least 5 cigarettes per day, are not currently receiving smoking cessation treatment, are in outpatient treatment with a medical provider, are receiving mood-stabilizing medication, and are interested in quitting smoking. Eligible participants attend six virtual treatment sessions (weeks 1-6) and a follow-up visit (week 10). Recruitment is conducted through online outreach resources including an internal Mass General Brigham study recruitment portal, ResearchMatch, and ClinicalTrials.Gov.

Two obstacles to recruitment have been observed so far: participant ineligibility and loss to follow-up. Recruitment began in November 2024, with 48 individuals so far indicating interest in this study. Most of these individuals were able to be reached for phone screening (n=35, 72.9% response rate), with 10 individuals found “likely eligible” at phone screening (28.6%) and 17 found to be ineligible at phone screening (48.6%). The remaining individuals either indicated a loss of interest (n=5) or are currently scheduled for a phone screening call (n=3). The most common reasons for ineligibility at phone screen were currently or in the past 3 months receiving smoking cessation treatment (n=4, 23.5%), not having an outpatient medical provider (n=4, 23.5%), and not endorsing symptoms consistent with bipolar disorder (n=3, 17.6%). All participants deemed “likely eligible” at phone screening were found to be eligible at the virtual screening visit (n=10). Among these participants (n=10), 6 have been lost to follow-up. Currently, 4 participants have completed or are currently active in the study trial.

To date, loss to follow-up and failure to meet eligibility criteria are the main recruitment obstacles for our study. To address these issues, we have included a pre-screening questionnaire to more accurately assess participant eligibility, increased study compensation to more adequately reflect assessment burden, and refined our study recruitment descriptions.