Novel Text-Messaging Bot in Patients Undergoing Joint Arthroplasty

February 13, 2023 updated by: Rush University Medical Center

Effectiveness of a Novel Text-Messaging Bot in Patients Undergoing Total Joint Arthroplasty: A Prospective Randomized Controlled Trial

This study evaluates the addition of an automated physician-specific text-messaging (SMS) bot in patients undergoing total joint arthroplasty. Half of the patients received the traditional perioperative education and instructions (control group), while the other half were enrolled in their physician's SMS bot (intervention group).

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

In an era of value-based reimbursement and high-volume surgery, the patient experience is becoming increasingly important. Despite publicized efforts to place a greater emphasis on patient-centered care, patients often report poor access to their physician, lack of effective perioperative education, and frustration as their care is commoditized.

A text-messaging (SMS) bot has the potential to help fill some of these voids. Bots are computer programs that are inherently automated to simulate human-like tasks. While a physician may wish he or she could contact each of their patients daily, it would be an impossible undertaking for most. An SMS bot could make daily contact possible by automating it, potentially improving patient education and engagement before and after surgery. Standard SMS has been previously reported to be an effective means for delivering timely information, increasing patient compliance and outcomes (medication adherence, decrease surgical infections with antiseptic showers), and reaching a socioeconomically diverse patient population. Further benefits may be seen with an SMS bot due to its automated capabilities.

Study Type

Interventional

Enrollment (Actual)

159

Phase

  • Not Applicable

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Inclusion criteria consisted of patients over 18 years of age, scheduled for primary total hip & knee arthroplasty, with smart phone capability, and proficiency in English.

Exclusion Criteria:

  • Patients less than 18 years of age, no smart phone capability, poor English proficiency.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Text Messaging (SMS) Bot
Patients undergoing total joint (hip & knee) arthroplasty will be enrolled in their physician's automated 'Text Messaging (SMS) Bot' in addition to receiving the routine perioperative education and instructions.
Other: Automated Text Messaging (SMS) Bot (intervention group)
Patients will be enrolled in an 'Automated Text Messaging (SMS) Bot (intervention group)' which is a computer program that sends patients timely reminders, instructions, and videos to help them prepare and recover from surgery.
Active Comparator: Routine Perioperative Instructions
Patients undergoing total joint (hip & knee) arthroplasty will receive only their 'Routine Perioperative Instructions'.
Other: Routine perioperative education & teaching (control group)
Patients will receive the 'Routine perioperative education & teaching (control group)' and will not be enrolled in the physician-specific SMS bot.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Time Participating in Home-Based Exercises
Time Frame: over a six-week time period after arthroplasty surgery
Stretching, strengthening, and other rehab-specific exercises counted toward their home-based exercises, while walking was excluded.
over a six-week time period after arthroplasty surgery

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Use of Narcotics/Opiates
Time Frame: over a six-week time period after arthroplasty surgery
Medications designated as "narcotics" included any medications that contained: hydrocodone, oxycodone, codeine, morphine, or tramadol. Patients were instructed to record their responses during the same two-hour window each day in a daily diary.
over a six-week time period after arthroplasty surgery
Calls to the Office
Time Frame: over a six-week time period after arthroplasty surgery
The number of patient calls to their physicians office were tracked and recorded.
over a six-week time period after arthroplasty surgery
Visits to the Emergency Department (ED)
Time Frame: over a six-week time period after arthroplasty surgery
The number of visits to the ED were tracked and recorded.
over a six-week time period after arthroplasty surgery
Knee Range of Motion
Time Frame: over a six-week time period after arthroplasty surgery
Degrees of flexion and extension of the operative knee will be measured at 6 weeks after surgery.
over a six-week time period after arthroplasty surgery
Visual Analog Scale (VAS) Mood Score
Time Frame: 6 weeks post-operative
VAS mood scores were collected from patients on the standard ten-point validated scale. If a patient circled two adjacent numbers on their daily diary, an average of the two numbers were assigned for that day. Minimum score 0. Maximum score 10. Higher score is worse outcome (more pain).
6 weeks post-operative
Number of Participants Reporting Satisfaction With Instruction Clarity
Time Frame: over a six-week time period after arthroplasty surgery
Patients were asked to fill out a satisfaction survey six weeks after surgery
over a six-week time period after arthroplasty surgery

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Rush University Medical Center

Investigators

  • Study Director: Kevin J Campbell, MD, Rush University Medical Center

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

November 21, 2016

Primary Completion (Actual)

August 1, 2017

Study Completion (Actual)

October 1, 2017

Study Registration Dates

First Submitted

December 24, 2017

First Submitted That Met QC Criteria

January 2, 2018

First Posted (Actual)

January 3, 2018

Study Record Updates

Last Update Posted (Actual)

November 22, 2023

Last Update Submitted That Met QC Criteria

February 13, 2023

Last Verified

February 1, 2023

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 16050101-IRB02

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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