Text Message-Based Nudges Prior to Primary Care Visits to Increase Care Gap Closure

Mitesh Patel

Status: Completed

Conditions: Breast Cancer; Diabetes Mellitus; Pneumonia, Pneumococcal; Colorectal Cancer

Treatments: Behavioral: Text message nudge

Study type: Interventional

Funder types: Industry

Identifiers

NCT05799976

RIN20230039

Details and patient eligibility

About

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.

Full 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.

Enrollment: 29,334 patients

Sex: All

Ages: 18+ years old

Volunteers: Accepts Healthy Volunteers

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

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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29,334 participants in 2 patient groups

Usual Care

No Intervention group

Description:

This is a group will serve as usual care and have no intervention during the study period

Text Message Group

Experimental group

Description:

This group of primary care practices will be randomized to have the text message intervention

Treatment:

Behavioral: Text message nudge