Abstract
Background
Prospective collection of patient-reported opioid consumption and pain levels post-surgically may hold value in highlighting solutions related to the opioid crisis. Traditional methods for collecting patient-reported outcomes after surgery, such as paper surveys, often have poor response rates, and electronic messaging may offer more convenience and therefore yield more robust data.
Questions/Purposes
The purpose of this study was to evaluate whether a novel mobile phone short message service (SMS) platform would lead to better patient response rates to surveys on pain and opioid use than data-collection tools.
Methods
An SMS text messaging platform was created and implemented between September 2017 and May 2018 at an orthopedic specialty hospital. The purpose was to collect reports on opioid consumption and pain levels twice a day for 6 weeks post-surgery from patients who had undergone total hip or knee arthroplasty or a single-level lumbar microdiscectomy or decompression spine surgery. Patients who responded to fewer than 50% of the text messages were excluded.
Results
Our mobile phone text messaging platform was used by 183 patients, demonstrating a significantly higher response rate (96.1%) than our institution’s post-operative email registry capture, as well as the majority of published response rates for post-operative outcomes captured through electronic and traditional data-collection systems. Response rate remained consistently high among the various surgeons and across patients, regardless of age.
Conclusions
This application of a widely available technology can improve the measurement of post-operative patient-reported outcomes. Such data can in turn be used in the development of strategies to reduce post-operative opioid use. The adoption of novel technologies at a patient level will play a key role in combating the opioid epidemic.
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Funding
This work was financially supported by a Hospital for Special Surgery surgeon-in-chief grant.
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Conflict of Interest
Jeffrey G. Stepan, MD, Msc, Cynthia A. Kahlenberg, MD, and Jason L. Blevins, MD, declare that they have no conflicts of interest. Ajay Premkumar, MD, MPH, and Francis C. Lovecchio, MD, report a surgeon-in-chief grant from the Hospital for Special Surgery in support of this study. Todd J. Albert, MD, reports personal fees from Biomet, FacetLink, Gentis, JP Medical Publishers, Saunders/Mosby-Elsevier, United Healthcare, and Thieme; grants and personal fees from DePuy; stock ownership in ASIP, Biometrix, Breakaway Imaging, Crosstree, FacetLink, Gentis, In ViVo Therapeutics, Paradigm Spine, Spinicity, and Vertech; salary from Weill-Cornell Medical College (professor) and Hospital for Special Surgery (surgeon-in-chief); non-financial support from Scoliosis Research Society (president), Cervical Spine Research Society (past-president), American Orthopaedic Association; grants from AO Foundation/Association for the Study of Internal Fixation, Patient-Centered Outcomes Research Institute, International Spine Study Group, and National Institute of Arthritis and Musculoskeletal and Skin Diseases, all outside the submitted work. Michael B. Cross, MD, reports personal fees from Link Orthopaedics, Smith & Nephew, and Zimmer; personal fees and research support from Acelity, Exactech, Inc., and Flexion Therapeutics; stock or stock options from Imagen, Insight Medical, and Parvizi Surgical Innovation; and personal fees, research support, and stock or stock options from Intellijoint, all outside the submitted work.
Human/Animal Rights
All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2013.
Informed Consent
Informed consent was obtained from all patients for being included in this study.
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Level of Evidence: IV
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Premkumar, A., Lovecchio, F.C., Stepan, J.G. et al. A Novel Mobile Phone Text Messaging Platform Improves Collection of Patient-Reported Post-operative Pain and Opioid Use Following Orthopedic Surgery. HSS Jrnl 15, 37–41 (2019). https://doi.org/10.1007/s11420-018-9635-3
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DOI: https://doi.org/10.1007/s11420-018-9635-3