Using Text Messaging in Long-Term Arthroplasty Follow-Up: A Pilot Study.

Oliver Blocker,Adel Ghandour,James Richardson,Rhidian Morgan-Jones,Alison Bullock

doi:10.2196/resprot.6047

Abstract

BackgroundPatient-reported outcome measures (PROMs) and mobile technology have the potential to change the way patients are monitored following joint replacement surgery.ObjectiveThe aim of this study was to determine the feasibility of text messaging to record PROMs in long-term follow-up of hip and knee arthroplasty. Our participants were 17 patients 2-years-plus post hip or knee arthroplasty attending clinic with a mobile telephone number on record.MethodsA simple PROM (Oswestry Very Short Form) was texted to the patient. Responses were compared to clinical, radiographic, and existing PROM findings. Patients were interviewed to discover their opinions on this use of texting.ResultsA total of 11 patients engaged with the text messaging. Reasons for not engaging included wrong numbers, physical barriers, and lack of understanding. A total of 8 patients attending clinic allowed comparison of text messaging with clinical findings. The average age was 70 years. A total of 4 patient text messaging responses matched clinical and radiographic findings; 3 also matched PROM scores collected in clinic. The 3 patients with mixed responses had abnormal clinical, radiographic, or PROM findings. One patient’s text responses conflicted with clinical outcome. Analysis of patients’ views showed a generally positive opinion: patients were happy to communicate with surgeons by text. Practical problems, PROM limitations, and trustworthiness of texting were highlighted.ConclusionsEngaging with changing technology creates challenges for patients and health care professionals. Despite this, our results suggest text messaging is a promising way to communicate with arthroplasty patients. Earlier integration of text communication in the patient pathway may be important and needs further research.

Highlights

In an ideal world, every patient who undergoes joint replacement surgery should be followed up for the remainder of the life of the prosthesis or the patient
Overview A total of 8 patients engaged with text messaging, attended clinic, and completed clinical evaluation, radiological assessment, and Patient-reported outcome measures (PROMs) scores
The typical values chosen by surgeons for the existing PROMs were an Oxford Knee Score (OKS) of 24 or less and an Harris Hip Score (HHS) of less than 70 as indicating a poor score needing surgical opinion [19]

Summary

Introduction

Every patient who undergoes joint replacement surgery should be followed up for the remainder of the life of the prosthesis or the patient. Long-term follow-up of all arthroplasty patients in clinic would probably outstrip the capacity of most orthopedic outpatient departments in the National Health Service (NHS). Patient-reported outcome measures (PROMs) are common in arthroplasty surgery [4]. Patient-reported outcome measures (PROMs) and mobile technology have the potential to change the way patients are monitored following joint replacement surgery. Our participants were 17 patients 2-years-plus post hip or knee arthroplasty attending clinic with a mobile telephone number on record. Results: A total of 11 patients engaged with the text messaging. A total of 8 patients attending clinic allowed comparison of text messaging with clinical findings. A total of 4 patient text messaging responses matched clinical and radiographic findings; 3 matched PROM scores collected in clinic. Our results suggest text messaging is a promising way to communicate with arthroplasty patients. Earlier integration of text communication in the patient pathway may be important and needs further research

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