1
|
Hanley K, Chung TH, Nguyen LK, Amadi T, Stansberry S, Yetman RJ, Foxhall LE, Bello R, Diallo T, Le YCL. Using Electronic Reminders to Improve Human Papillomavirus (HPV) Vaccinations among Primary Care Patients. Vaccines (Basel) 2023; 11:vaccines11040872. [PMID: 37112784 PMCID: PMC10145812 DOI: 10.3390/vaccines11040872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 04/14/2023] [Accepted: 04/18/2023] [Indexed: 04/29/2023] Open
Abstract
The COVID-19 pandemic led to delays in routine preventative primary care and declines in HPV immunization rates. Providers and healthcare organizations needed to explore new ways to engage individuals to resume preventive care behaviors. Thus, we evaluated the effectiveness of using customized electronic reminders with provider recommendations for HPV vaccination to increase HPV vaccinations among adolescents and young adults, ages 9-25. Using stratified randomization, participants were divided into two groups: usual care (control) (N = 3703) and intervention (N = 3705). The control group received usual care including in-person provider recommendations, visual reminders in exam waiting rooms, bundling of vaccinations, and phone call reminders. The intervention group received usual care and an electronic reminder (SMS, email or patient portal message) at least once, and up to three times (spaced at an interval of 1 reminder per month). The intervention group had a 17% statistically significantly higher odds of uptake of additional HPV vaccinations than the usual care group (Adjusted Odds Ratio: 1.17, 95% CI: 1.01-1.36). This work supports previous findings that electronic reminders are effective at increasing immunizations and potentially decreasing healthcare costs for the treatment of HPV-related cancers.
Collapse
Affiliation(s)
- Kathleen Hanley
- Department of Healthcare Transformation Initiatives, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - Tong Han Chung
- Department of Healthcare Transformation Initiatives, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - Linh K Nguyen
- Department of Healthcare Transformation Initiatives, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - Tochi Amadi
- Department of Healthcare Transformation Initiatives, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - Sandra Stansberry
- Department of Healthcare Transformation Initiatives, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - Robert J Yetman
- Department of Pediatrics, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - Lewis E Foxhall
- Office of Health Policy, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Rosalind Bello
- Office of Health Policy, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
- The HPV Vaccination Initiative, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Talhatou Diallo
- Department of Healthcare Transformation Initiatives, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - Yen-Chi L Le
- Department of Healthcare Transformation Initiatives, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| |
Collapse
|
2
|
Lee MT, Acevedo A, Garnick DW, Horgan CM, Panas L, Ritter GA, Campbell KM. Impact of Agency Receipt of Incentives and Reminders on Engagement and Continuity of Care for Clients With Co-Occurring Disorders. Psychiatr Serv 2018; 69:804-811. [PMID: 29695226 PMCID: PMC6193487 DOI: 10.1176/appi.ps.201700465] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
OBJECTIVE This study examined whether having co-occurring substance use and mental disorders influenced treatment engagement or continuity of care and whether offering financial incentives, client-specific electronic reminders, or a combination to treatment agencies improved treatment engagement and continuity of care among clients with co-occurring disorders. METHODS The study used a randomized cluster design to assign agencies (N=196) providing publicly funded substance use disorder treatment in Washington State to a research arm: incentives only, reminders only, incentives and reminders, and a control condition. Data were analyzed for 76,044 outpatient, 32,797 residential, and 39,006 detoxification admissions from Washington's treatment data system. Multilevel logistic regressions were conducted, with clients nested within agencies, to examine the effect of the interventions on treatment engagement and continuity of care. RESULTS Compared with clients with a substance use disorder only, clients with co-occurring disorders were less likely to engage in outpatient treatment or have continuity of care after discharge from residential treatment, but they were more likely to have continuity of care after discharge from detoxification. The interventions did not influence treatment engagement or continuity of care, except the reminders had a positive impact on continuity of care after residential treatment among clients with co-occurring disorders. CONCLUSIONS In general, the interventions did not result in improved treatment engagement or continuity of care. The limited number of significant results supporting the influence of incentives and alerts on treatment engagement and continuity of care add to the mixed findings reported by previous research. Multiple interventions may be needed for performance improvement.
Collapse
Affiliation(s)
- Margaret T Lee
- With the exception of Dr. Campbell, the authors are with the Institute for Behavioral Health, Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts. Dr. Acevedo is also with the Department of Community Health, Tufts University, Medford, Massachusetts. Dr. Campbell is with the Division of Behavioral Health and Recovery, Washington State Behavioral Health Administration, Olympia
| | - Andrea Acevedo
- With the exception of Dr. Campbell, the authors are with the Institute for Behavioral Health, Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts. Dr. Acevedo is also with the Department of Community Health, Tufts University, Medford, Massachusetts. Dr. Campbell is with the Division of Behavioral Health and Recovery, Washington State Behavioral Health Administration, Olympia
| | - Deborah W Garnick
- With the exception of Dr. Campbell, the authors are with the Institute for Behavioral Health, Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts. Dr. Acevedo is also with the Department of Community Health, Tufts University, Medford, Massachusetts. Dr. Campbell is with the Division of Behavioral Health and Recovery, Washington State Behavioral Health Administration, Olympia
| | - Constance M Horgan
- With the exception of Dr. Campbell, the authors are with the Institute for Behavioral Health, Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts. Dr. Acevedo is also with the Department of Community Health, Tufts University, Medford, Massachusetts. Dr. Campbell is with the Division of Behavioral Health and Recovery, Washington State Behavioral Health Administration, Olympia
| | - Lee Panas
- With the exception of Dr. Campbell, the authors are with the Institute for Behavioral Health, Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts. Dr. Acevedo is also with the Department of Community Health, Tufts University, Medford, Massachusetts. Dr. Campbell is with the Division of Behavioral Health and Recovery, Washington State Behavioral Health Administration, Olympia
| | - Grant A Ritter
- With the exception of Dr. Campbell, the authors are with the Institute for Behavioral Health, Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts. Dr. Acevedo is also with the Department of Community Health, Tufts University, Medford, Massachusetts. Dr. Campbell is with the Division of Behavioral Health and Recovery, Washington State Behavioral Health Administration, Olympia
| | - Kevin M Campbell
- With the exception of Dr. Campbell, the authors are with the Institute for Behavioral Health, Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts. Dr. Acevedo is also with the Department of Community Health, Tufts University, Medford, Massachusetts. Dr. Campbell is with the Division of Behavioral Health and Recovery, Washington State Behavioral Health Administration, Olympia
| |
Collapse
|
3
|
Haley EM, Meisel D, Gitelman Y, Dingfield L, Casarett DJ, O'Connor NR. Electronic Goals of Care Alerts: An Innovative Strategy to Promote Primary Palliative Care. J Pain Symptom Manage 2017; 53:932-937. [PMID: 28062333 DOI: 10.1016/j.jpainsymman.2016.12.329] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Revised: 11/20/2016] [Accepted: 12/23/2016] [Indexed: 01/13/2023]
Abstract
CONTEXT Given the shortage of palliative care specialists, strategies are needed to promote primary palliative care by nonpalliative care providers. Electronic reminders are frequently used in medicine to standardize practice, but their effectiveness in encouraging goals of care discussions is not well understood. OBJECTIVES To determine whether brief education and electronic alerts increase the frequency of goals of care discussions. METHODS All general medicine services at a large academic medical center were included. Each medicine team received brief education on rounds about goals of care communication tool. When a newly admitted patient met predefined criteria, an electronic alert that included the tool was sent to the patient's resident and attending physicians within 48 hours. RESULTS Of 352 admissions screened over a four-week period, 18% met one or more criteria. The combination of alerts and education increased documentation of goals of care in the medical record from 20.5% (15/73) to 44.6% (25/56) of patients (risk ratio 2.17, 95% CI 1.23-3.72). There were no significant changes in code status, noncode status limitations in care, or palliative care consultation. CONCLUSION The combination of brief education and electronic goals of care alerts significantly increased documented goals of care discussions. This intervention is simple and feasible in many settings, but larger studies are needed to determine impact on patient outcomes.
Collapse
Affiliation(s)
- Erin M Haley
- Department of Medicine at the University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Deborah Meisel
- Department of Medicine at the University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Yevgeniy Gitelman
- Department of Medicine at the University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Laura Dingfield
- Department of Medicine at the University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - David J Casarett
- Department of Medicine at Duke University School of Medicine, Durham, North Carolina, USA
| | - Nina R O'Connor
- Department of Medicine at the University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA. nina.o'
| |
Collapse
|
4
|
Bogart K, Wong SK, Lewis C, Akenzua A, Hayes D, Prountzos A, Okocha CI, Kravariti E. Mobile phone text message reminders of antipsychotic medication: is it time and who should receive them? A cross-sectional trust-wide survey of psychiatric inpatients. BMC Psychiatry 2014; 14:15. [PMID: 24447428 PMCID: PMC3922751 DOI: 10.1186/1471-244x-14-15] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2013] [Accepted: 01/18/2014] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Poor adherence to antipsychotic medication is a widespread problem, and the largest predictor of relapse in patients with psychosis. Electronic reminders are increasingly used to improve medication adherence for a variety of medical conditions, but have received little attention in the context of psychotic disorders. We aimed to explore the feasibility and acceptability of including short message service (SMS) medication reminders in the aftercare plan of service users discharged from inpatient care on maintenance antipsychotic medication. METHODS We conducted a cross-sectional, trust-wide survey in the inpatient units of the Oxleas National Health Service (NHS) Foundation Trust in the UK between June 29 and August 3, 2012. Using a self-report questionnaire and the Drug Attitude Inventory, we examined inpatient attitudes towards antipsychotic drugs, past adherence to antipsychotic medication, frequency of mobile phone ownership, and interest in receiving SMS medication reminders upon discharge from the ward. Predictors of a patient's interest in receiving electronic reminders were examined using simple logistic regression models. RESULTS Of 273 inpatients, 85 met eligibility criteria for the survey, showed decisional capacity, and agreed to participate. Of the 85 respondents, over a third (31-35%) admitted to have forgotten to take/collect their antipsychotic medication in the past, and approximately half (49%) to have intentionally skipped their antipsychotics or taken a smaller dose than prescribed. Male patients (55%), those with negative attitudes towards antipsychotics (40%), and those unsatisfied with the information they received on medication (35%) were approximately 3 to 4 times more likely to report past intentional poor adherence. The large majority of respondents (80-82%) reported having a mobile phone and knowing how to use SMS, and a smaller majority (59%) expressed an interest in receiving SMS medication reminders after discharge. No variable predicted a patient's interest in receiving electronic reminders of antipsychotics. CONCLUSIONS Automatic SMS reminders of antipsychotic medication were acceptable to the majority of the survey respondents as an optional service offered upon discharge from inpatient care. Automatic electronic reminders deserve further investigation as a flexible, minimally invasive, cost-effective and broadly applicable tool that can potentially improve antipsychotic adherence and clinical outcomes.
Collapse
Affiliation(s)
- Katherine Bogart
- Department of Psychosis Studies, Institute of Psychiatry at the Maudsley, King’s College London, De Crespigny Park, Denmark Hill, London SE5 8AF, UK,Wandsworth Psychological Therapies and Wellbeing, Springfield University Hospital, 61 Glenburnie Road, London SW17 7DJ, UK
| | - Sook Kuan Wong
- Department of Psychosis Studies, Institute of Psychiatry at the Maudsley, King’s College London, De Crespigny Park, Denmark Hill, London SE5 8AF, UK
| | - Christine Lewis
- Bexley Crisis Resolution and Home Treatment Team, Erith Centre, Park Crescent, Erith DA8 3EE, UK
| | - Anthony Akenzua
- Oxleas NHS Foundation Trust, Pinewood House, Pinewood Place, Dartford, Kent DA2 7WG, UK
| | - Daniel Hayes
- Department of Psychosis Studies, Institute of Psychiatry at the Maudsley, King’s College London, De Crespigny Park, Denmark Hill, London SE5 8AF, UK
| | - Athanasios Prountzos
- Department of Psychosis Studies, Institute of Psychiatry at the Maudsley, King’s College London, De Crespigny Park, Denmark Hill, London SE5 8AF, UK
| | - Chike Ify Okocha
- Oxleas NHS Foundation Trust, Pinewood House, Pinewood Place, Dartford, Kent DA2 7WG, UK
| | - Eugenia Kravariti
- Department of Psychosis Studies, Institute of Psychiatry at the Maudsley, King's College London, De Crespigny Park, Denmark Hill, London SE5 8AF, UK.
| |
Collapse
|
5
|
Abstract
Social workers are often involved with patients and families around adherence, both to clinic appointments as well as to the medication regimen. An evidence-based practice project was created and implemented to determine the efficacy of electronic reminders such as text messaging on adherence. The implications of improving adherence can positively impact the patient on an individual level as well as reduce costs and increase revenue at a systems level.
Collapse
|
6
|
Greaney ML, Puleo E, Sprunck-Harrild K, Bennett GG, Cunningham MA, Gillman MW, Coeling M, Emmons KM. Electronic reminders for cancer prevention: factors associated with preference for automated voice reminders or text messages. Prev Med 2012; 55:151-4. [PMID: 22659227 PMCID: PMC4077718 DOI: 10.1016/j.ypmed.2012.05.014] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2012] [Revised: 05/15/2012] [Accepted: 05/22/2012] [Indexed: 10/28/2022]
Abstract
OBJECTIVE Prompting may promote engagement with behavior change interventions. Prompts can be delivered inexpensively via automated voice response (AVR) reminders or short message service (SMS) text messages. We examined the association between participants' characteristics and preferred reminder modality. METHODS Healthy Directions 2 is a cluster randomized controlled trial implemented in Boston, Massachusetts to promote change in multiple behavioral cancer risk factors. At baseline (2009), participants completed a survey assessing socio-demographics, health status, height/weight, and factors associated with technology. One-third of participants randomized to receive the intervention (n=598) were randomized to receive automated reminders, with participants selecting modality. RESULTS 28% (167/598) of participants selected SMS reminders. Controlling for clustering by primary care provider, younger participants (OR=0.97, 95% CI=(0.95, 0.99), p<0.01), those most comfortable with computers (very uncomfortable OR=0.54, 95% CI=(0.29, 1.01), p≤0.05: referent group = very comfortable), and those who frequently sent/received text messages (never OR=0.09 CI=(0.04, 0.16) p<0.01; 1-3 times/month OR=0.38, 95% CI=(0.15, 0.93) p=0.04: referent group=1-5 times/week) were more likely to choose SMS. CONCLUSIONS Interventions should make both modalities available to ensure that more participants can benefit from prompting. Studies examining the effect of automated reminders may have reduced effectiveness or generalizability if they employ only one modality.
Collapse
Affiliation(s)
- Mary L Greaney
- Center for Community-Based Research, Dana-Farber Cancer Institute, Boston, MA 02215, USA.
| | | | | | | | | | | | | | | |
Collapse
|
7
|
Abstract
BACKGROUND Therapeutic nonadherence is defined as the lack of equivalence between the behavior of the patients and their prescribed medical treatment. Consequences of nonadherence include not only health outcomes, but also cost saving. Thus, this issue gets paramount importance in contemporary medicine. METHOD The aim of this article is to discuss the relationships between technology and adherence by asking the following three questions. (1) How can technology be used to monitor patient adherence? (2) Considering the mechanisms of nonadherence in chronic diseases, is there room for technology in interventions aimed to improve patient adherence? (3) What about adherence to technology in diabetes care? RESULTS AND CONCLUSION Technology may help improve adherence to long-term therapies by (1) giving a concrete representation of adherence rewards, (2) overcoming immediate obstacles to adherence, such as the fear of hypoglycemia, and (3) providing an opportunity for patient-doctor conversations. This assumes, however, that both the patient and the doctor are convinced that technologies are useful.
Collapse
Affiliation(s)
- Gérard Reach
- Department of Endocrinology, Diabetes and Metabolic Diseases, Avicenne Hospital, Bobigny, France.
| |
Collapse
|