Mobile Phone Based Telemonitoring for Improving Adherence to Analgesic Treatment in Trauma Patients After Emergency Department Discharge. Randomized Controlled Trial

Abstract

Objective: To determine the impact of mobile-phone telemonitoring on patients’ adherence and satisfaction to post-trauma pain treatment. Materials and Methods: We conducted a prospective randomized clinical trial including patients with minor trauma discharged from the emergency department (ED) with analgesic treatment. Patients were randomized to one of three groups, control group where patients received a phone call on day-7, short message service (SMS) group where patients received a daily text message to remind them to take their treatment during 7 days and mobile-phone based telemonitoring (TLM) group. Patients’ adherence to analgesic treatments using the Morisky Medication Adherence Scale (MMAS-4), current pain by using a visual analogue scale (VAS) and patients’ satisfaction were assessed. For TLM group, assessment was performed at day-2, 4 and 7. Results: Good adherence was observed in 418 patients (92.9%) in TLM group versus 398 patients (88.6%) in SMS group and 380 patients (84.8%) in control group (P<0.001). The factor mostly associated with adherence was telemonitoring (OR 2.40 95% CI 1.55 to 3.71). The decrease of pain VAS was highest in TLM group compared to SMS and control groups (P<0.001). Percentage of patients’ satisfaction at 7-day post ED discharge was 93% in TLM group vs 88% in SMS group and 84% in standard group (P=0.02). Discussion: Our findings suggest that mobile-phone based telemonitoring is beneficial in the treatment of pain in trauma patients after ED discharge. This approach improved patients’ adherence and satisfaction.