NCT05799976

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

A Pragmatic Randomized Intervention Using Text Messages Prior to Primary Care Visits to Encourage Care Gap Closure: The PRIME Randomized Clinical Trial

• Status: Completed
• Phase: N/A
• Study type: Interventional
• Enrollment: 29,334 (actual)
• Sponsor: Mitesh Patel · Industry
• Sex: All
• Age: 18 Years
• Healthy volunteers: Accepted

Summary

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.

Detailed 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.

Conditions

• Pneumonia, Pneumococcal
• Diabetes Mellitus
• Breast Cancer
• Colorectal Cancer

Interventions

Type	Name	Description
BEHAVIORAL	Text message nudge	The text message nudge will be sent to patients 3 days and 1 day prior to a visit with the primary care practices and notify them of up to 3 care gaps based on electronic health record data. Care gaps will be selected based on availability and ranked in this order: influenza vaccination, pneumococcal vaccination, breast cancer screening, colorectal cancer screening, hemoglobin A1 testing, or statin therapy.

Timeline

• Start date: 2023-09-05
• Primary completion: 2023-11-09
• Completion: 2024-02-09
• First posted: 2023-04-05
• Last updated: 2024-04-25

Locations

1 site across 1 country: United States