A Pragmatic Randomized Controlled Crossover Study to Evaluate the Impact of Messaging Interventions on Emergency Department Utilization Among Oncology Patients at Parkland Health
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 入组人数
- 200
- 试验地点
- 1
- 主要终点
- Time to the next cancer treatment related ED visit.
研究概览
简要总结
This pragmatic randomized controlled study evaluates an education intervention designed to increase patient engagement with Oncology Acute Care (OAC) services among patients being treated for cancer at Parkland Health.
Eligible patients will be randomized to either a control (usual care) arm or an intervention arm. If a patient in the control group has experiences a subsequent cancer treatment related ED visit without documented OAC engagement, they will be moved to the intervention arm. Patients in the intervention arm will receive an automated MyChart message and text message within 24 hours of hospital discharge reinforcing oncology acute care (OAC) resources, including contact information for the triage line and guidance for when to seek urgent versus emergency care. Messages will be resent at 48 and 72 hours if unviewed. Once the message is viewed, the patient will enter an outcome tracking period to monitor time to subsequent ED visit or OAC contact. Follow-up will occur in 3-month intervals until an outcome is documented or the study ends.
After randomization, patients will be monitored on an observation list for outcomes including OAC contact and cancer treatment-related Emergency Department (ED) visits. Patients who contact OAC clinic will be removed from observation list and complete the study. We will repeat the observation period and document outcomes if the patient has a subsequent cancer treatment-related ED visits without documented OAC engagement.
详细描述
Overview:
This study is a pragmatic randomized controlled crossover trial designed to evaluate the feasibility and impact of structured follow-up messaging interventions on patient engagement with Oncology Acute Care (OAC) services and reduction in cancer treatment-related Emergency Department (ED) visits at Parkland Health.
Recruitment and Enrollment:
Eligible patients will be identified using an automated dashboard through Parkland's Epic electronic health record system based on the inclusion/Exclusion criteria. Patients meeting criteria will be automatically flagged for study enrollment. No active consent will be required as the intervention involves standard communication methods already available to patients (MyChart and text messaging), and the study poses minimal risk.
Randomization and Crossover Design:
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Crossover
- 主要目的
- Health Services Research
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Age ≥ 18 years.
- •Active cancer diagnosis
- •Actively receiving chemotherapy treatment
- •ED Arrival within 30 days of chemotherapy treatment
- •Discharged home following ED visit, observation, or inpatient stay
- •Enrolled in MyChart with valid mobile number and language preference recorded (English or Spanish)
排除标准
- •Not enrolled in MyChart or lacking a valid mobile phone number.
- •Language preference not recorded or not English/Spanish (if messaging is only available in these languages).
- •Receiving hospice or palliative care services, where acute symptom management goals may differ.
- •Patients admitted directly to inpatient care without ED visit
研究组 & 干预措施
Control Arm (Usual Care)
Patients receive standard hospital discharge instructions without additional messaging Patients in the control arm who experience a subsequent cancer treatment-related ED visit without documented OAC engagement will be crossed over to the intervention arm.
Intervention Arm
Patients receive structured follow-up messages using existing education materials via MyChart and automated text messaging within 24, 48, and 72 hours post-discharge.
干预措施: Follow-up messaging (Other)
结局指标
主要结局
Time to the next cancer treatment related ED visit.
时间窗: 2 years maximum
Evaluate whether structured MyChart + text messaging after hospital/ED discharge decreases time to the next cancer treatment-related ED visit compared with usual care.
次要结局
- Patient Engagement with OAC(2 years maximum)
- Message Engagement(2 years maximum)
- Evaluate Feasibility(2 years maximum)
- Identify Patient Subgroups(2 years maximum)
研究者
Arthur Hong
Associate Professor
University of Texas Southwestern Medical Center