Mobile Phone-administered Triage Tool to Followup on Discharged Trauma Patients
- Conditions
- Wounds and Injury
- Interventions
- Other: Mobile Phone-based Triage Tool
- Registration Number
- NCT03805646
- Lead Sponsor
- University of California, Los Angeles
- Brief Summary
After being admitted to and then discharged from a hospital in Cameroon for having experienced an injury, there is no established way for the health system to check in on how the discharged person is doing. The investigators have developed a set of questions with the hope that asking these questions--over the phone--to those who have been discharged from the hospital will allow them to determine which post-discharge patients would benefit from further care. The investigators believe that asking these questions over the phone is a good way of determining which post-discharge trauma patients would benefit from further care.
- Detailed Description
Broadly, this study aims to answer three questions. (1) Is it feasible to call discharged trauma patients on their mobile phones to check up on them? (2) Can a defined set of questions help determine which discharged trauma patients require further medical care (and which discharged trauma patients do not require further medical care)? (3) Will checking in on discharged trauma patients reduce their experience of disability and economic consequences?
If an individual was a trauma patient who was admitted at and then discharged from one of the study's partner hospitals in Cameroon, the discharged individual (hereafter referred to as "the participant') will be receiving phone calls from one of the study's research assistants at the following post-discharge timepoints: 2 weeks, 1 month, 3 months, and 6 months. Whether the research assistant administers the defined set of questions developed by the study's investigators (see question 2, above) will depend on when the participant was discharged from the hospital. Regardless, all participants will be asked other important questions about the injury and any associated disabilities and economic consequences.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 3990
- All trauma registry patients at participating hospitals who provided cellphone numbers and are alive at hospital discharge are eligible for inclusion regardless of age, injury severity, or hospital disposition status.
Not provided
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Mobile Phone-administered Triage Tool Mobile Phone-based Triage Tool For each hospital site: After the first six months of baseline data collection, the mobile phone-administered triage tool (or "Mobile Phone-based Triage Tool") will be implemented for a year.
- Primary Outcome Measures
Name Time Method Proportion of Successful Contacts 2 weeks after enrollment The number of successful contacts will be divided by the total number of contacts. A "successful" contact is when an enrolled patient answered the phone, and consented to the research assistant administering the questionnaire(s) planned for that phone call.
Median Number of Attempts Required to Achieve a Successful Contact 2 weeks after enrollment This is the median number of call attempts made until a research assistant is able to successfully administer the questionnaire(s) planned for that phone call.
Median Cost Associated With Personnel Time At the end of the study (2 weeks after the 2-year intervention phase (extended due to COVID)) This measure is median monthly costs incurred to pay the research assistant for the time s/he spends making the required phone calls per patient.
Median Cost Associated With Telephone Time At the end of the study (2 weeks after the 2-year intervention phase (extended due to COVID)) This measure is the median costs incurred to make phone calls per patient in each study phase.
Telephone Triage Tool Administration Time After administration of the telephone triage tool (i.e. about 2 weeks after enrollment) This measure will be calculated based on how much time it takes to administer the telephone triage tool.
Physician Assessment of Whether a Patient Would Benefit From Further Services Immediately after the physician administers the physical exam (i.e. about 3 weeks after enrollment) This is a binary measure. After a physician examines a participant, s/he will determine whether s/he thinks the participant would benefit from further services (including additional follow-up care, and/or diagnostic or therapeutic interventions).
Physician Assessment of Whether a Patient Was at Moderate to High Risk for a Poor Outcome (HR) Without Additional Intervention Immediately after the physician administers the physical exam (i.e. about 3 weeks after enrollment) After a physician examines a participant, s/he will determine whether s/he thinks the participant is at low, moderate or high risk for a poor outcome (HR) without additional intervention using subjective clinical assessment.
Triage Risk Score (TRS) At the end of intervention phase (about 1 year after enrollment). To develop a sensitive model capable of risk stratifying triaged patients for high risk (HR), all candidate questions from the telephone triage tool found to associate with HR on univariate regression were weighted by their predictive coefficient and added to generate a triage risk score (TRS) ranging from a minimum score of 0 (lowest risk) to a maximum possible score of 43.9 (highest risk). Triage Risk Score (TRS) less than or equal to 1.3 (1st quartile) was designated as low risk, TRS 1.4 to 4.0 (2nd \& 3rd quartile) as moderate risk, and TRS greater than or equal to 4.1 (fourth quartile) as high risk.
Acceptability Score of Mobile Phones as a Follow-up Tool 2 weeks after enrollment This is a numerical measure that represents the sum of the positive responses that participants give to each question that assesses the acceptability of mobile phones as a follow-up tool. The scale for the acceptability score of mobile phones as a follow-up tool ranges from 0 to 6, where 0 means the participant's responses indicate the participant believes mobile phones are definitely not an acceptable follow-up tool and 6 means the participant's responses indicate the participant believes mobile phones are definitely an acceptable follow-up tool.
Proportion of Injured Patients Who Seek Clinical Follow-up Evaluation After the 2week post-discharge phonecall. This will be calculated as follows: The denominator will be the number of discharged trauma patients enrolled in the study. The numerator will be the number of discharged trauma patients enrolled in the study who seek any clinical follow-up evaluation at the 2 weeks post-discharge phonecall.
- Secondary Outcome Measures
Name Time Method Glasgow Outcomes Scale-Extended (GOSE) Disability Level At the 2week post-discharge telephone phonecall. The GOSE disability level that participants in the study report. For each participant, GOSE disability level will be determined using the augmented GOSE (aGOSE) instrument, which assesses factors like the participant's independence inside and outside the home, work, social and leisure activities, family and friendship, etc. Each time after administration of the aGOSE instrument, the participant's GOSE disability level will be calculated. The aGOSE score is reported for the 2-week post-discharge timepoint.
The Glasgow Outcome Scale (GOS) is a global scale for functional outcome that rates patient status into one of five categories (worse to best respectively): Dead, Vegetative State, Severe Disability, Moderate Disability or Good Recovery. The Extended GOS (GOSE) which was used in this study provides more detailed categorization into eight categories by subdividing the categories of severe disability, moderate disability and good recovery into a lower and upper category.Economic Consequences of Injury: Did it Become More Difficult for the Family to Afford Expenses Such as Food and Rent? At the 2week post-discharge telephone phonecall. Participants were asked if following the injury it became more difficult for the family to afford expenses such as food and rent.
Economic Consequences of Injury: Did the Family Spend Saved Money? At the 2week post-discharge telephone phonecall. Participants were asked if following the injury the family had to spend their savings.
Economic Consequences of Injury: Did the Family Borrow Money? At the 2week post-discharge telephone phonecall. Participants were asked if following the injury the family had to borrow money to meet up with expenses.
Trial Locations
- Locations (4)
Laquintinie Hospital
🇨🇲Douala, Cameroon
Edea Regional Hospital
🇨🇲Edea, Cameroon
Limbé Regional Referral Hospital
🇨🇲Limbe, Cameroon
Pouma Catholic Hospital
🇨🇲Pouma, Cameroon