A Pragmatic Randomized Intervention Using Text Messages Prior to Primary Care Visits to Encourage Care Gap Closure: The PRIME Randomized Clinical Trial
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Pneumonia, Pneumococcal
- Sponsor
- Mitesh Patel
- Enrollment
- 29334
- Locations
- 1
- Primary Endpoint
- Care gap order rate
- Status
- Completed
- Last Updated
- 2 years ago
Overview
Brief Summary
Primary care visits are a key aspect of clinical care focused on helping patients to close care gaps related to preventive care such as vaccination, diabetes testing, statin therapy and cancer screening. However, less than 50% of care gaps are closed during these visits and new approaches are needed to prime patients for a discussion during these visits. In this study, the study team will evaluate a health system initiative that uses text messaging to patients in days preceding a primary care visit to prime patients to be amenable to ordering of vaccination, diabetes testing, cancer screening, and statin prescribing.
Detailed Description
The United States Preventive Services Task Force has recommended tests and treatments for vaccination, diabetes testing, statin therapy, and cancer screening. These preventive services have been demonstrated to reduce illness and improve quality of care. Yet, more than 50% of open care gaps go unaddressed during primary care visits. Nudges are subtle changes to the way information is framed or choices are offered that can have a significant impact on behavior. In a previous randomized clinical trial, text messages sent to patients prior to primary care visits increased vaccination by up to 11% relative to control. The most effective message told patients the influenza vaccine was "reserved for you," and sent two text messages to patients in the 3 days preceding a primary care appointment.
Investigators
Mitesh Patel
VP, Ascension
Ascension Health
Eligibility Criteria
Inclusion Criteria
- •Age 18 or older
- •Have documented consent to communicate electronically
- •Have a visit scheduled with a primary care practice
- •Have at least one open care gap among those in the intervention
Exclusion Criteria
- •No phone number on file to send text messages
Outcomes
Primary Outcomes
Care gap order rate
Time Frame: By the end of the day of the primary care visit
The proportion of open care gaps that have a test or treatment ordered to address them