Recruitment of trial participants through electronic medical record patient portal messaging: A pilot study
Timothy B Plante, Kelly T Gleason, Hailey N Miller, Jeanne Charleston, Kristen McArthur, Cheryl Dennison Himmelfarb, Mariana Lazo, Daniel E Ford, Edgar R Miller 3rd, Lawrence J Appel, Stephen P Juraschek, STURDY Collaborative Research Group, Nicole Cronin, Scott McClure, Jennifer Miskimon, Christine M Mitchell, Rita R Kalyani, David L Roth, Jennifer A Schrack, Sarah L Szanton, Jacek Urbanek, Jeremy Walston, Amal Wanigatunga, Sheriza N Baksh, Amanda L Blackford, Shumon Chattopadhyay, Lea T Drye, John Dodge, Cathleen Ewing, Sana Haider, Stephanie C Holland, Rosetta Jackson, Andrea Lears, Curtis Meinert, David Shade, Michael Smith, Alice L Sternberg, James Tonascia, Mark L Van Natta, Annette Wagoner, George W Comstock, Erin D Michos, J Denise Bennett, Pamela Bowers, Josef Coresh, Patricia Crowley, Tammy Crunkleton, Briana Dick, Rebecca Evans, Mary Godwin, Lynne Hammann, Deborah Hawks, Karen Horning, Erika Hull, Brandi Mills, Melissa Minotti, Leann Raley, Amanda Reed, Rhonda Reeder, Cassie Reid, Melissa Shuda, Adria Spikes, Rhonda Stouffer, Kelly Weicht, Caroline Abbas, Bernellyn Carey, Syree Davis, Naomi DeRoche-Brown, Debra Gayles, Sherlina Holland, Ina Glenn-Smith, Duane Johnson, Mia Johnson, Eva Keyes, Danielle Santiago, Chanchai Sapun, Valerie Sneed, Lee Swartz, Letitia Thomas, Robert H Christenson, Show-Hong Duh, Heather Rebuck, Clifford Rosen, Tom Cook, Pamela Duncan, Karen Hansen, Anne Kenny, Sue Shapses, Judy Hannah, Sergei Romashkan, Cindy D Davis, Christopher T Sempos, Jack M Guralnik, J C Gallagher, Timothy B Plante, Kelly T Gleason, Hailey N Miller, Jeanne Charleston, Kristen McArthur, Cheryl Dennison Himmelfarb, Mariana Lazo, Daniel E Ford, Edgar R Miller 3rd, Lawrence J Appel, Stephen P Juraschek, STURDY Collaborative Research Group, Nicole Cronin, Scott McClure, Jennifer Miskimon, Christine M Mitchell, Rita R Kalyani, David L Roth, Jennifer A Schrack, Sarah L Szanton, Jacek Urbanek, Jeremy Walston, Amal Wanigatunga, Sheriza N Baksh, Amanda L Blackford, Shumon Chattopadhyay, Lea T Drye, John Dodge, Cathleen Ewing, Sana Haider, Stephanie C Holland, Rosetta Jackson, Andrea Lears, Curtis Meinert, David Shade, Michael Smith, Alice L Sternberg, James Tonascia, Mark L Van Natta, Annette Wagoner, George W Comstock, Erin D Michos, J Denise Bennett, Pamela Bowers, Josef Coresh, Patricia Crowley, Tammy Crunkleton, Briana Dick, Rebecca Evans, Mary Godwin, Lynne Hammann, Deborah Hawks, Karen Horning, Erika Hull, Brandi Mills, Melissa Minotti, Leann Raley, Amanda Reed, Rhonda Reeder, Cassie Reid, Melissa Shuda, Adria Spikes, Rhonda Stouffer, Kelly Weicht, Caroline Abbas, Bernellyn Carey, Syree Davis, Naomi DeRoche-Brown, Debra Gayles, Sherlina Holland, Ina Glenn-Smith, Duane Johnson, Mia Johnson, Eva Keyes, Danielle Santiago, Chanchai Sapun, Valerie Sneed, Lee Swartz, Letitia Thomas, Robert H Christenson, Show-Hong Duh, Heather Rebuck, Clifford Rosen, Tom Cook, Pamela Duncan, Karen Hansen, Anne Kenny, Sue Shapses, Judy Hannah, Sergei Romashkan, Cindy D Davis, Christopher T Sempos, Jack M Guralnik, J C Gallagher
Abstract
Background/aim: Cost-efficient methods are essential for successful participant recruitment in clinical trials. Patient portal messages are an emerging means of recruiting potentially eligible patients into trials. We assessed the response rate and complaint rate from direct-to-patient, targeted recruitment through patient portals of an electronic medical record for a clinical trial, and compared response rates by differences in message content.
Methods: The Study to Understand Fall Reduction and Vitamin D in You (STURDY) trial is a National Institutes of Health-sponsored, community-based study of vitamin D supplementation for fall prevention in older adults conducted at Johns Hopkins. Potential participants were identified using the Epic electronic medical record at the Johns Hopkins Health System based on age (≥70 years), ZIP code (30-mile radius of study site), and prior activation of a patient portal account. We prepared a shorter message and a longer message. Both had basic information about study participation, but the longer message also contained information about the significance of the study and a personal invitation from the STURDY principal investigator. The Hopkins Institutional Review Board did not require prior consent from the patient or their providers. We calculated the response rate and tracked the number of complaints and requests for removal from future messages. We also determined response rate according to message content.
Results: Of the 5.5 million individuals receiving care at the Johns Hopkins Health System, a sample of 6896 met our inclusion criteria and were sent one patient portal recruitment message between 6 April 2017 and 3 August 2017. Assessment of enrollment by this method ended on 1 December 2017. There were 116 patients who expressed interest in the study (response rate: 1.7%). Twelve (0.2%) recipients were randomized. There were two complaints (0.03%) and one request to unsubscribe from future recruitment messages (0.01%). Response rate was higher with the longer message than the shorter message (2.1% vs 1.2%; p = 0.005).
Conclusion: Patient portal messages inviting seniors to participate in a randomized controlled trial resulted in a response rate similar to commercial email marketing and resulted in very few complaints or opt-out requests. Furthermore, a longer message with more content enhanced response rate. Recruitment through patient portals might be an effective strategy to enroll trial participants.
Trial registration: ClinicalTrials.gov NCT02166333.
Keywords: Clinical trial; electronic medical records; patient portal messages; randomized controlled trial; recruitment methods.
Conflict of interest statement
Disclosures
The authors report no conflicts of interest.
Figures
Source: PubMed