Text messaging research participants as a follow-up strategy to decrease emergency department study attrition

Abstract

Objective: Collecting patient-reported follow-up data for prospective studies in the emergency department (ED) is challenging in this minimal continuity setting. The objective of this study was to determine whether text messaging study participants involved in an ongoing randomized trial resulted in a lower rate of attrition as compared to conventional telephone follow-up. Methods: This was a nested cohort analysis of research participants enrolled in a randomized controlled trial assessing head injury discharge instructions. During the first 4 months of study follow-up, participants were contacted by a conventional telephone call. For the final 3 months, participants were contacted by text messaging following the first failed telephone attempt. Results: A total of 118 patients were enrolled in the study (78 underwent conventional follow-up, and 40 received text messages). During the period of conventional follow-up, 3 participants withdrew from the study. Of the remaining 75 participants, 24 (32.0%) at 2 weeks and 32 (42.7%) at 4 weeks were unable to be contacted. Of the 40 participants receiving a reminder text message, 4 (10.0%) at 2 weeks and 10 (25.0%) at 4 weeks were unable to be contacted. Overall, text messaging study participants decreased attrition by 22% (95% CI: 5.9%, 34.7%) and 17.7% (95% CI: -0.8%, 33.3%) at 2-and 4-week follow-ups, respectively. Conclusions: In this ED cohort participating in a randomized trial, text message reminders of upcoming telephone followup interviews decreased the rate of attrition. Text messaging is a viable, low-cost communication strategy that can improve follow-up participation in prospective research studies. RÉSUMÉIntroduction: La collecte de données sur le suivi des patients en vue d'études prospectives au service des urgences (SU) présente des difficultés dans un contexte de continuité

Protocol for a mixed-methods feasibility study for the surviving opioid overdose with naloxone education and resuscitation (SOONER) randomised control trial

“…Published strategies to improve participant retention include the involvement of community members in study design and implementation, cash and comfort compensation for study participation, regular follow-up through multiple communications media, building trust and improving communication around trial methods, and flexible hours and scheduling for follow-up assessments 29 30 34 36. Attention to patient-centred, destigmatising and participatory language in research processes may also enhance participant recruitment and retention 42.…”

“…Limited financial resources mean that many participants may not have daytime telephone ‘minutes’ and do not take incoming calls, preferring instead to communicate by text message. We emphasise the use of text message reminders, drawing on research demonstrating the feasibility and effectiveness of text messaging for participant retention in randomised trials 34…”

Non-randomised evaluations of strategies to increase participant retention in randomised controlled trials: a systematic review

“…Five retention studies used a prospective cohort study design [25,29,33,36,39]. Two retention studies used a historical control study design [32,35].…”

“…Two studies evaluated two different reminder strategies to increase response rate and decrease participant attrition [33,34] (Table 3). Again, the specific retention strategies used in studies under this category were different and this precluded a meta-analysis.…”

Towards an Effective Patient Health Engagement System Using Cloud-Based Text Messaging Technology

“…Among all cell phone activities, text messaging (TM), also known as the short messaging service (SMS), is the most prevalent, both in overall likelihood and frequency [12] . Studies have demonstrated that TM can be an effective PRO collection technology for health interventions [9] , [13] , [14] , clinical management [15] – [18] , and health-related behavior modification [19] , [20] . In addition, TM extends the capacity for monitoring outpatient disease complications (e.g., frequency and duration/resolution of painful episodes), potentially reducing hospitalizations.…”