The Wisconsin Predicting Patients' Relapse questionnaire

Abstract

Introduction: Relapse is the most common smoking cessation outcome. Accurate prediction of relapse likelihood could be an important clinical tool used to infl uence treatment selection or duration. The aim of this research was to develop a brief clinical relapse proneness questionnaire to be used with smokers interested in quitting in a clinical setting where time is at a premium. Methods:Diverse items assessing constructs shown in previous research to be related to relapse risk, such as nicotine dependence and self-effi cacy, were evaluated to determine their independent contributions to relapse prediction. In an exploratory dataset, candidate items were assessed among smokers motivated to quit smoking who enrolled in one of three randomized controlled smoking cessation trials. A cross-validation dataset was used to compare the relative predictive power of the new instrument against the Fagerström Test for Nicotine Dependence (FTND) at 1-week, 8-week, and 6-month postquit assessments. Results:We selected seven items with relatively nonoverlapping content for the Wisconsin Predicting Patient's Relapse (WI-PREPARE) measure, a brief, seven-item questionnaire that taps physical dependence, environmental factors, and individual difference characteristics. Cross-validation analyses suggested that the WI-PREPARE demonstrated a stronger prediction of relapse at 1-week and 8-week postquit assessments than the FTND and comparable prediction to the FTND at a 6-month postquit assessment. Discussion:The WI-PREPARE is easy to score, suggests the nature of a patient's relapse risk, and predicts short-and medium-term relapse better than the FTND.

Probability and predictors of cannabis use disorders relapse: Results of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC)

“…Several sociodemographic variables, indicators of substance use severity and psychopathology predicted relapse in the univariate analyses. In the multivariable models, only having a history of conduct disorder or a diagnosis of new onset major depressive disorder or dysthymia after Wave 1 increased the risk of relapse, indicating that other variables previously identified as risk factors for relapse in clinical samples of CUD (Stephens et al, 1994b) and other SUD (Bolt et al, 2009; Catalano et al, 1990; Ramo et al, 2005) no longer increased the risk of relapse after adjusting for the effect of other covariates. This pattern of results remained unchanged when individuals in partial remission were included or the analyses were restricted to participants who had been in remission for one year at the baseline assessment.…”

Rates and Predictors of Renewed Quitting After Relapse During a One-Year Follow-Up Among Primary Care Patients

“…Two additional items from the craving subscale of the WISDM-68 (“I usually want to smoke right after I wake up”, “How strong are your urges when you first wake up in the morning?”) were also administered. These were the four items from the WISDM that seemed to best predict relapse proneness in the early stages of the development of the Wisconsin Predicting Patients’ Relapse Questionnaire (WI-PREPARE, 39). Scores on each pair of items were averaged to create an index of environmental risk and morning craving, respectively.…”

Treating Smokers in the Health Care Setting

“…Counseling also warns of obstacles or hurdles to quitting, and encourages the patient to plan and use coping strategies to avoid and resist temptations or urges (Table 1). The clinician should assess and counsel regarding factors that pose especially great challenges to quitting 3 , such as living with a smoker, excessive alcohol use, and fear of gaining weight (Table 2) 36 . Counseling should be empathic and supportive, not confrontational 3 .…”