Telephone follow-up surveys included four self-report adherence indices: total number of days varenicline was taken over the approximately 6-month study period, proportion of varenicline taken 7 days prior to quit date, proportion selleck chemicals of varenicline taken 7 days post quit date (Mannheimer, Friedland, Matts, Child, & Chesney, 2002), and the Morisky Medication Adherence Questionnaire (MAQ) at 21 days and 12 weeks post quit date (Morisky, Green, & Levine, 1986). The MAQ has been validated with smokers and yields a total score and two subscales that measure purposeful nonadherence (e.g., purposefully stopping medication after feeling better or worse) and unintentional nonadherence (e.g., careless or forgetful in taking medication; Toll et al., 2007). Participants respond yes or no to four MAQ items assessing history of medication nonadherence.

Items are scored 0 (yes) or 1 (no) and summed such that higher MAQ total or subscale scores reflect higher adherence/lower nonadherence (Morisky et al., 1986; Toll et al., 2007). At each follow-up point, participants were asked if they were still taking varencline. Those participants who had stopped taking varenicline were asked to indicate ��yes�� or ��no�� for each reason for stopping: experienced side effects, felt it was not needed, and felt it was not working. Participants still taking the medication were assigned a ��no�� answer for each of these items. Integrated Medication and Behavioral Interventions All COMPASS trial participants received a prescription from a study physician for a 12-week supply of varenicline to be taken according to recommended guidelines (Fiore et al.

, 2008) starting one week prior to the target quit date. The study protocol was for the central Group Health pharmacy to mail a starter supply of varenicline and up to two 28-day prescription refills (upon request) to each participant who set a quit date at no charge to the participant. Smokers (n = 1,202) were randomized to receive one of three delivery modes of cessation counseling (phone, Web, and integrated phone/Web), and all those who set a quit date (n = 1,161; 96.6%) received varenicline. We previously reported high cessation rates (33%) but no significant differences across study arms at 6 months (Swan et al., 2010).

In this paper, the Batimastat relationship of varenicline adherence to smoking abstinence at 6 months post quit date is examined for the 1,161 COMPASS participants who were mailed varenicline prescriptions, regardless of intervention arm assignment. Statistical Analysis Logistic regression analysis was used to evaluate the relationship of each medication adherence measure to smoking outcome at 6-month follow-up (Table 2). Chi-square analysis was used to compare the reasons for stopping varenicline given by smokers and nonsmokers (Table 3).