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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).
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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Text Messaging (SMS) Bot | Experimental | 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. |
|
| Routine Perioperative Instructions | Active Comparator | Patients undergoing total joint (hip & knee) arthroplasty will receive only their 'Routine Perioperative Instructions'. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Automated Text Messaging (SMS) Bot (intervention group) | Other | 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. |
| Measure | Description | Time Frame |
|---|---|---|
| Time Participating in Home-Based Exercises | 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 |
| Measure | Description | Time Frame |
|---|---|---|
| Knee Range of Motion | 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 |
| Use of Narcotics/Opiates |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Kevin J Campbell, MD | Rush University Medical Center | Study Director |
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| ID | Title | Description |
|---|---|---|
| FG000 | 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. 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. |
| FG001 | Routine Perioperative Instructions | Patients undergoing total joint (hip & knee) arthroplasty will receive only their 'Routine Perioperative Instructions'. 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. |
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
nothing different from the assignment in Participant Flow
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| ID | Title | Description |
|---|---|---|
| BG000 | 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. 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. |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | Count of Participants |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | ||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Time Participating in Home-Based Exercises | Stretching, strengthening, and other rehab-specific exercises counted toward their home-based exercises, while walking was excluded. | Posted | Mean | Standard Deviation | minutes | over a six-week time period after arthroplasty surgery |
|
6 weeks.
Does not differ.
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | 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. 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. |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Presentation to the Emergency Department | Musculoskeletal and connective tissue disorders | Non-systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Dr Philip Louie | Rush University Medical Center | 2539069256 | louie.philip@gmail.com |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot_SAP | Yes | Yes | No | Study Protocol and Statistical Analysis Plan | Jan 19, 2017 | Dec 17, 2022 | Prot_SAP_000.pdf |
| ICF | No | No | Yes | Informed Consent Form | Jan 19, 2017 | Dec 17, 2022 | ICF_001.pdf |
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| ID | Term |
|---|---|
| D020370 | Osteoarthritis, Knee |
| D015207 | Osteoarthritis, Hip |
| ID | Term |
|---|---|
| D010003 | Osteoarthritis |
| D001168 | Arthritis |
| D007592 | Joint Diseases |
| D009140 | Musculoskeletal Diseases |
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| ID | Term |
|---|---|
| D013097 | Spermine Synthase |
| D004522 | Educational Status |
| D035061 | Control Groups |
| ID | Term |
|---|---|
| D019883 | Alkyl and Aryl Transferases |
| D014166 | Transferases |
| D004798 | Enzymes |
| D045762 | Enzymes and Coenzymes |
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|
| Routine perioperative education & teaching (control group) | Other | Patients will receive the 'Routine perioperative education & teaching (control group)' and will not be enrolled in the physician-specific SMS bot. |
|
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 |
| Visual Analog Scale (VAS) Mood Score | 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 |
| Calls to the Office | The number of patient calls to their physicians office were tracked and recorded. | over a six-week time period after arthroplasty surgery |
| Number of Participants Reporting Satisfaction With Instruction Clarity | Patients were asked to fill out a satisfaction survey six weeks after surgery | over a six-week time period after arthroplasty surgery |
| Visits to the Emergency Department (ED) | The number of visits to the ED were tracked and recorded. | over a six-week time period after arthroplasty surgery |
| BG001 | Routine Perioperative Instructions | Patients undergoing total joint (hip & knee) arthroplasty will receive only their 'Routine Perioperative Instructions'. 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. |
| BG002 | Total | Total of all reporting groups |
| Participants |
|
| Age, Continuous | Mean | Standard Deviation | years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Ethnicity (NIH/OMB) | Data not collected. | Count of Participants | Participants |
|
| Routine Perioperative Instructions |
Patients undergoing total joint (hip & knee) arthroplasty will receive only their 'Routine Perioperative Instructions'. 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. |
|
|
| Secondary | Knee Range of Motion | Degrees of flexion and extension of the operative knee will be measured at 6 weeks after surgery. | Posted | Mean | Standard Deviation | degrees | over a six-week time period after arthroplasty surgery |
|
|
|
| Secondary | Use of Narcotics/Opiates | 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. | Posted | Mean | Standard Deviation | days | over a six-week time period after arthroplasty surgery |
|
|
|
| Secondary | Visual Analog Scale (VAS) Mood Score | 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). | Posted | Mean | Standard Deviation | score on a scale | 6 weeks post-operative |
|
|
|
| Secondary | Calls to the Office | The number of patient calls to their physicians office were tracked and recorded. | Posted | Mean | Standard Deviation | number of calls | over a six-week time period after arthroplasty surgery |
|
|
|
| Secondary | Number of Participants Reporting Satisfaction With Instruction Clarity | Patients were asked to fill out a satisfaction survey six weeks after surgery | Posted | Count of Participants | Participants | over a six-week time period after arthroplasty surgery |
|
|
|
| Secondary | Visits to the Emergency Department (ED) | The number of visits to the ED were tracked and recorded. | Posted | Number | visits | over a six-week time period after arthroplasty surgery |
|
|
|
| 0 |
| 76 |
| 0 |
| 76 |
| 0 |
| 76 |
| EG001 | Routine Perioperative Instructions | Patients undergoing total joint (hip & knee) arthroplasty will receive only their 'Routine Perioperative Instructions'. 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. | 0 | 83 | 4 | 83 | 0 | 83 |
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| D012216 |
| Rheumatic Diseases |
| D012959 |
| Socioeconomic Factors |
| D011154 | Population Characteristics |
| D015340 | Epidemiologic Research Design |
| D004812 | Epidemiologic Methods |
| D008919 | Investigative Techniques |
| D012107 | Research Design |
| D008722 | Methods |