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Home/Large Joints and Extremities/Study: Texting Boosts Patient Engagement
Large Joints and Extremities

Study: Texting Boosts Patient Engagement

March 4, 2019 1 min read Premium comments

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Study: Texting Boosts Patient Engagement
Courtesy of STREAMD
#totalhiparthroplasty#totaljointarthroplastySecondary#visualanalogscores

Research from Rush University in Chicago and the University of Washington in Seattle has determined that patients who receive text messages are more engaged and recover faster.

Their work, “A Novel, Automated Text-Messaging System Is Effective in Patients Undergoing Total Joint Arthroplasty,” appears in the January 16, 2019 edition of The Journal of Bone and Joint Surgery.

The randomized trial involved 159 patients who had undergone primary total hip or knee replacement.

The authors wrote, “All patients received standard education, including instructions on home exercises after surgery. In addition, one group of patients received a series of automated, physician-specific text messages. The pre-programmed texts provided recovery instructions along with encouraging and empathetic messages, personalized video messages from the surgeon, and brief instructional therapy videos…”

Co-author Kevin Campbell, M.D., CEO and co-founder of STREAMD, the service that sent the messages, not only sponsored the study but touted its outcomes to OTW, “We were most intrigued to discover that patients who were enrolled in STREAMD spent fewer days on narcotics, had fewer emergency room visits, placed fewer calls to the surgeon’s office, had increased satisfaction and VAS [Visual Analog Scores] mood scores, spent more time on home therapy exercises, and had a faster return of motion.”

“We also documented STREAMD’s effectiveness in reducing narcotic use. With automated reminders and tips about safely weaning off narcotics, patients enrolled in STREAMD after hip and knee replacement stopped their opiate medications 10 days sooner than a matched group of patients who were not enrolled. We’re very encouraged by this finding and are inspired to explore it further, given the profound clinical and economic impact of decreasing opiate consumption after joint replacement surgery.”

Referring to the 10-day reduction in opioid use Dr. Campbell stated, “This finding could be related to improved patient education and to the encouraging and empathetic tone of the text and video messages. It could also reflect improved mood scores and patients’ confidence in their ability to manage their recovery, which have been shown to be very effective pain relievers.”

React:

Discussion

14
DS
Dr. Sarah MitchellOrthopedic Surgeon · Mayo Clinic

This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?

8
JT
James Thornton, MDSpine Fellow · HSS

Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.

5
RP
R. PatelSports Medicine · Stanford

We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.

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