Text messaging intervention improved outcomes in patients with unexpected surgical delays
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Results showed psychological intervention delivered via automated mobile messaging robots improved function and outcomes in patients who experienced unexpected surgical delays during the COVID-19 pandemic.
Chris A. Anthony, MD, and colleagues at the University of Iowa performed a randomized controlled trial to determine the effectiveness of acceptance and commitment therapy (ACT) delivered via a mobile phone messaging robot to 90 patients scheduled for total hip arthroplasty or total knee arthroplasty and whose surgery was delayed due to the COVID-19 pandemic.
Patients in the ACT group received two daily automated mobile phone messages for 14 days. Additionally, researchers analyzed a control group, which consisted of patients who received no messages.
Patient-Reported Outcome Measure Information System (PROMIS) physical health scores, Hip Disability and Osteoarthritis Outcome Score for Joint Replacement (HOOS JR) scores and Knee Injury and Osteoarthritis Outcome Score for Joint Replacement scores were collected before and after intervention.
Anthony and colleagues found 38% of the ACT group and 17.5% of the control group achieved minimal clinically important differences (MCID) in PROMIS physical health scores; 24% of the ACT group and 2.5% of the control group achieved MCID in HOOS JR scores; and 29% of the ACT group and 4.2% of the control group achieved MCID in KOOS JR scores. They also noted 41.7% of the control group experienced a clinically important decline in KOOS JR scores, while 14% of the ACT group experienced a decline in KOOS JR scores.
“As COVID-19 and its variants remain active throughout the United States, it is likely that health care systems will continue to have unexpected surgical cancellations either due to worsening outbreaks or hospital protocols requiring postponement of surgery for patients who test positive in the days prior to their procedure,” the researchers wrote in the study. They concluded, “Health care systems should consider utilization of an ACT messaging protocol to preserve physical function and joint-specific PROMs when caring for patients.”
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