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Anjala Tess - One of the best experts on this subject based on the ideXlab platform.
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using a patient internet portal to prevent adverse drug events a randomized controlled trial
Journal of Patient Safety, 2013Co-Authors: Saul N. Weingart, Anjala Tess, Laurel Chiappetta, Sherri Tutkus, Laurinda Morway, Russell S Phillips, Alexander R Carbo, Roger B. Davis, Mária Tóth, David W. BatesAbstract:OBJECTIVES: Adverse drug events (ADEs) are common in ambulatory care and may result from poor patient-physician communication about medication-related symptoms. A module was developed within an Electronic patient portal that was designed to enhance communication about medication symptoms and, in turn, reduce ADEs and health-care utilization. METHODS: The researchers conducted a randomized, controlled clinical trial of MedCheck, an automated Electronic Message generated in a patient Internet portal. MedCheck asked intervention patients if they had filled a recent prescription and if they had experienced any problems with the medication. Patients' responses were forwarded automatically to primary care physicians. The study enrolled 375 intervention patients and 363 controls. After 3 months, the investigators reviewed patients' medical records and conducted telephone interviews to identify ADEs and to assess health-care utilization. RESULTS: Among the 375 intervention patients, 184 (49%) responded to at least 1 MedCheck Message. Patients reported 52 unfilled prescriptions and 56 medication problems. Patients responded to 72% of Messages within 1 day. There was no statistically significant difference between intervention and control groups in the rate of ADEs, preventable or ameliorable ADEs, serious ADEs, or in subjects' health-care utilization. CONCLUSIONS: Internet portals have the potential to enhance patient-physician communication. However, additional development is required to demonstrate that such interventions can improve medication safety or health-care utilization.
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medication safety Messages for patients via the web portal the medcheck intervention
International Journal of Medical Informatics, 2008Co-Authors: Anjala Tess, Sherri Tutkus, Saul N. Weingart, Alexander R Carbo, Hope E Hamrick, Daniel Z SandsAbstract:Abstract Objective Communication failures account for many adverse drug events (ADEs) in adult primary care. Improving patient–physician communication may improve medication safety. Accordingly, the goal of this study was to learn whether Electronic medication safety Messages directed to patients can improve communication about medications and identify ADEs. Design We studied adult patients enrolled in a patient Internet portal at three primary care practices affiliated with a teaching hospital. MedCheck, a medication safety application, sent patients a secure Electronic Message 10 days after they received a new or changed prescription. MedCheck asked if the patient had filled the prescription or experienced medication-related problems, and then forwarded the patient's response to their primary care physician. Measurements We selected a stratified random sample of 267 subjects from 1821 patients who received and opened a MedCheck Message from April 2001 to June 2002. We reviewed subjects’ medical records for three months following their first MedCheck Message. We analyzed patient and clinician response rates and times, examined patient–clinician communication about medications, and identified ADEs. Results Patients opened 79% of MedCheck Messages and responded to 12%; 77% responded within 1 day. Patients often identified problems filling their prescriptions (48%), problems with drug effectiveness (12%), and medication symptoms (10%). Clinicians responded to 68% of patients’ Messages; 93% answered within 1 week. Clinicians often supplied or requested information (19%), or made multiple recommendations (15%). Patients experienced 21 total ADEs; they reported 17 Electronically. Conclusion Patients and physicians responded promptly to patient-directed Electronic medication Messages, identifying and addressing medication-related problems including ADEs.
Saul N. Weingart - One of the best experts on this subject based on the ideXlab platform.
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using a patient internet portal to prevent adverse drug events a randomized controlled trial
Journal of Patient Safety, 2013Co-Authors: Saul N. Weingart, Anjala Tess, Laurel Chiappetta, Sherri Tutkus, Laurinda Morway, Russell S Phillips, Alexander R Carbo, Roger B. Davis, Mária Tóth, David W. BatesAbstract:OBJECTIVES: Adverse drug events (ADEs) are common in ambulatory care and may result from poor patient-physician communication about medication-related symptoms. A module was developed within an Electronic patient portal that was designed to enhance communication about medication symptoms and, in turn, reduce ADEs and health-care utilization. METHODS: The researchers conducted a randomized, controlled clinical trial of MedCheck, an automated Electronic Message generated in a patient Internet portal. MedCheck asked intervention patients if they had filled a recent prescription and if they had experienced any problems with the medication. Patients' responses were forwarded automatically to primary care physicians. The study enrolled 375 intervention patients and 363 controls. After 3 months, the investigators reviewed patients' medical records and conducted telephone interviews to identify ADEs and to assess health-care utilization. RESULTS: Among the 375 intervention patients, 184 (49%) responded to at least 1 MedCheck Message. Patients reported 52 unfilled prescriptions and 56 medication problems. Patients responded to 72% of Messages within 1 day. There was no statistically significant difference between intervention and control groups in the rate of ADEs, preventable or ameliorable ADEs, serious ADEs, or in subjects' health-care utilization. CONCLUSIONS: Internet portals have the potential to enhance patient-physician communication. However, additional development is required to demonstrate that such interventions can improve medication safety or health-care utilization.
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medication safety Messages for patients via the web portal the medcheck intervention
International Journal of Medical Informatics, 2008Co-Authors: Anjala Tess, Sherri Tutkus, Saul N. Weingart, Alexander R Carbo, Hope E Hamrick, Daniel Z SandsAbstract:Abstract Objective Communication failures account for many adverse drug events (ADEs) in adult primary care. Improving patient–physician communication may improve medication safety. Accordingly, the goal of this study was to learn whether Electronic medication safety Messages directed to patients can improve communication about medications and identify ADEs. Design We studied adult patients enrolled in a patient Internet portal at three primary care practices affiliated with a teaching hospital. MedCheck, a medication safety application, sent patients a secure Electronic Message 10 days after they received a new or changed prescription. MedCheck asked if the patient had filled the prescription or experienced medication-related problems, and then forwarded the patient's response to their primary care physician. Measurements We selected a stratified random sample of 267 subjects from 1821 patients who received and opened a MedCheck Message from April 2001 to June 2002. We reviewed subjects’ medical records for three months following their first MedCheck Message. We analyzed patient and clinician response rates and times, examined patient–clinician communication about medications, and identified ADEs. Results Patients opened 79% of MedCheck Messages and responded to 12%; 77% responded within 1 day. Patients often identified problems filling their prescriptions (48%), problems with drug effectiveness (12%), and medication symptoms (10%). Clinicians responded to 68% of patients’ Messages; 93% answered within 1 week. Clinicians often supplied or requested information (19%), or made multiple recommendations (15%). Patients experienced 21 total ADEs; they reported 17 Electronically. Conclusion Patients and physicians responded promptly to patient-directed Electronic medication Messages, identifying and addressing medication-related problems including ADEs.
Christopher D. Gardner - One of the best experts on this subject based on the ideXlab platform.
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To Text or Not to Text: Electronic Message Intervention to Improve Treatment Adherence Versus Matched Historical Controls.
JMIR mHealth and uHealth, 2019Co-Authors: Marily Oppezzo, Michael V. Stanton, Ariadna Garcia, Joseph Rigdon, Jae R Berman, Christopher D. GardnerAbstract:BACKGROUND Ensuring treatment adherence is important for the internal validity of clinical trials. In intervention studies where touch points decrease over time, there is even more of an adherence challenge. Trials with multiple cohorts offer an opportunity to innovate on ways to increase treatment adherence without compromising the integrity of the study design, and previous cohorts can serve as historical controls. Electronically delivered nudges offer low-cost opportunities to increase treatment adherence. OBJECTIVE This study aimed to evaluate the effectiveness of Electronic Messages (e-Messages) on treatment adherence to the last cohort of a parent weight loss intervention during the second half of a year-long trial, when intervention checkpoint frequency decreases. Treatment adherence is measured by intervention class attendance and adherence to the intervention diet. METHODS All participants in the last cohort (cohort 5, n=128) of a large randomized weight loss study were offered an e-Message intervention to improve participant adherence during the last 6 months of a 1-year weight loss program. Overall, 3 to 4 Electronic weekly Messages asked participants about intervention diet adherence. A propensity score model was estimated using 97 participants who opted to receive e-Messages and 31 who declined in cohort 5 and used to pair match cohort 5 e-Message participants to a historical control group from cohorts 1 to 4. Moreover, 88 participants had complete data, yielding 176 participants in the final analyses. After matching, intervention and matched control groups were compared on (1) proportion of class attendance between the 6 and 12 month study endpoints, (2) diet adherence, as measured by total carbohydrate grams for low-carbohydrate (LC) and total fat grams for low-fat (LF) diets at 12 months, and (3) weight change from 6 to 12 months. The dose-response relationship between the proportion of text Messages responded to and the 3 outcomes was also investigated. RESULTS Compared with matched controls, receiving e-Messages had no effect on (1) treatment adherence; class attendance after 6 months +4.6% (95% CI -4.43 to 13.68, P=.31), (2) adherence; LC -2.5 g carbohydrate, 95% CI -29.9 to 24.8, P=.85; LF +6.2 g fat, 95% CI -4.1 to 17.0, P=.26); or on (3) the secondary outcome of weight change in the last 6 months; +0.3 kg (95% CI -1.0 to 1.5, P=.68). There was a positive significant response correlation between the percentage of Messages to which participants responded and class attendance (r=.45, P
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to text or not to text Electronic Message intervention to improve treatment adherence versus matched historical controls
Jmir mhealth and uhealth, 2019Co-Authors: Marily Oppezzo, Michael V. Stanton, Ariadna Garcia, Joseph Rigdon, Jae R Berman, Christopher D. GardnerAbstract:BACKGROUND Ensuring treatment adherence is important for the internal validity of clinical trials. In intervention studies where touch points decrease over time, there is even more of an adherence challenge. Trials with multiple cohorts offer an opportunity to innovate on ways to increase treatment adherence without compromising the integrity of the study design, and previous cohorts can serve as historical controls. Electronically delivered nudges offer low-cost opportunities to increase treatment adherence. OBJECTIVE This study aimed to evaluate the effectiveness of Electronic Messages (e-Messages) on treatment adherence to the last cohort of a parent weight loss intervention during the second half of a year-long trial, when intervention checkpoint frequency decreases. Treatment adherence is measured by intervention class attendance and adherence to the intervention diet. METHODS All participants in the last cohort (cohort 5, n=128) of a large randomized weight loss study were offered an e-Message intervention to improve participant adherence during the last 6 months of a 1-year weight loss program. Overall, 3 to 4 Electronic weekly Messages asked participants about intervention diet adherence. A propensity score model was estimated using 97 participants who opted to receive e-Messages and 31 who declined in cohort 5 and used to pair match cohort 5 e-Message participants to a historical control group from cohorts 1 to 4. Moreover, 88 participants had complete data, yielding 176 participants in the final analyses. After matching, intervention and matched control groups were compared on (1) proportion of class attendance between the 6 and 12 month study endpoints, (2) diet adherence, as measured by total carbohydrate grams for low-carbohydrate (LC) and total fat grams for low-fat (LF) diets at 12 months, and (3) weight change from 6 to 12 months. The dose-response relationship between the proportion of text Messages responded to and the 3 outcomes was also investigated. RESULTS Compared with matched controls, receiving e-Messages had no effect on (1) treatment adherence; class attendance after 6 months +4.6% (95% CI -4.43 to 13.68, P=.31), (2) adherence; LC -2.5 g carbohydrate, 95% CI -29.9 to 24.8, P=.85; LF +6.2 g fat, 95% CI -4.1 to 17.0, P=.26); or on (3) the secondary outcome of weight change in the last 6 months; +0.3 kg (95% CI -1.0 to 1.5, P=.68). There was a positive significant response correlation between the percentage of Messages to which participants responded and class attendance (r=.45, P<.001). CONCLUSIONS Although this e-Message intervention did not improve treatment adherence, future studies can learn from this pilot and may incorporate more variety in the prompts and more interaction to promote more effective user engagement. Uniquely, this study demonstrated the potential for innovating within a multicohort trial using propensity score-matched historical control subjects. TRIAL REGISTRATION ClinicalTrials.gov NCT01826591; https://clinicaltrials.gov/ct2/show/NCT01826591. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.1016/j.cct.2016.12.021.
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To Text or Not to Text: Electronic Message Intervention to Improve Treatment Adherence Versus Matched Historical Controls (Preprint)
2018Co-Authors: Marily Oppezzo, Michael V. Stanton, Ariadna Garcia, Joseph Rigdon, Jae R Berman, Christopher D. GardnerAbstract:BACKGROUND Ensuring treatment adherence is important for the internal validity of clinical trials. In intervention studies where touch points decrease over time, there is even more of an adherence challenge. Trials with multiple cohorts offer an opportunity to innovate on ways to increase treatment adherence without compromising the integrity of the study design, and previous cohorts can serve as historical controls. Electronically delivered nudges offer low-cost opportunities to increase treatment adherence. OBJECTIVE This study aimed to evaluate the effectiveness of Electronic Messages (e-Messages) on treatment adherence to the last cohort of a parent weight loss intervention during the second half of a year-long trial, when intervention checkpoint frequency decreases. Treatment adherence is measured by intervention class attendance and adherence to the intervention diet. METHODS All participants in the last cohort (cohort 5, n=128) of a large randomized weight loss study were offered an e-Message intervention to improve participant adherence during the last 6 months of a 1-year weight loss program. Overall, 3 to 4 Electronic weekly Messages asked participants about intervention diet adherence. A propensity score model was estimated using 97 participants who opted to receive e-Messages and 31 who declined in cohort 5 and used to pair match cohort 5 e-Message participants to a historical control group from cohorts 1 to 4. Moreover, 88 participants had complete data, yielding 176 participants in the final analyses. After matching, intervention and matched control groups were compared on (1) proportion of class attendance between the 6 and 12 month study endpoints, (2) diet adherence, as measured by total carbohydrate grams for low-carbohydrate (LC) and total fat grams for low-fat (LF) diets at 12 months, and (3) weight change from 6 to 12 months. The dose-response relationship between the proportion of text Messages responded to and the 3 outcomes was also investigated. RESULTS Compared with matched controls, receiving e-Messages had no effect on (1) treatment adherence; class attendance after 6 months +4.6% (95% CI −4.43 to 13.68, P=.31), (2) adherence; LC −2.5 g carbohydrate, 95% CI −29.9 to 24.8, P=.85; LF +6.2 g fat, 95% CI −4.1 to 17.0, P=.26); or on (3) the secondary outcome of weight change in the last 6 months; +0.3 kg (95% CI −1.0 to 1.5, P=.68). There was a positive significant response correlation between the percentage of Messages to which participants responded and class attendance (r=.45, P<.001). CONCLUSIONS Although this e-Message intervention did not improve treatment adherence, future studies can learn from this pilot and may incorporate more variety in the prompts and more interaction to promote more effective user engagement. Uniquely, this study demonstrated the potential for innovating within a multicohort trial using propensity score–matched historical control subjects. CLINICALTRIAL ClinicalTrials.gov NCT01826591; https://clinicaltrials.gov/ct2/show/NCT01826591
K.s. Virgo - One of the best experts on this subject based on the ideXlab platform.
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Evaluation of alternate Messages on an Electronic Message strip to recruit subjects to a smoking‐cessation program
Journal of cancer education : the official journal of the American Association for Cancer Education, 1995Co-Authors: Frank E. Johnson, Terence P. Wade, William G. Kraybill, Katranides M, Margaret A. Coplin, K.s. VirgoAbstract:Abstract The authors previously published details of a method to evaluate the effectiveness of Electronic Message strips in recruiting subjects to a smoking‐cessation program. They now report data suggesting that a shorter, more negative Message yields better results than a longer, more positive Message. The data also show that this approach increases the number of subjects who enroll in a smoking‐cessation program and the number of subjects who actually quit smoking.
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Evaluation of an Electronic Message strip to recruit smokers to a smoking cessation program.
Journal of cancer education : the official journal of the American Association for Cancer Education, 1993Co-Authors: Frank E. Johnson, Janine C. Edwards, Marianne L. Currie, Margaret Katranides, K.s. Virgo, James Daly, Terence P. Wade, William G. KraybillAbstract:Abstract Knowledge of outcome is essential when analyzing effectiveness of educational programs. Although quantitative data can be analyzed more rigorously than other forms of data, quantitation of behavioral processes is often difficult. To promote our smoking‐cessation program we designed a method that relies on Electronic Message strips and a dedicated telephone line capable of providing quantitative outcome information. This approach appears quite versatile and shows that the Electronic Message strip is a surprisingly ineffective method of enlisting subjects into a smoking‐cessation program in our hospital.
William G. Kraybill - One of the best experts on this subject based on the ideXlab platform.
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Evaluation of alternate Messages on an Electronic Message strip to recruit subjects to a smoking‐cessation program
Journal of cancer education : the official journal of the American Association for Cancer Education, 1995Co-Authors: Frank E. Johnson, Terence P. Wade, William G. Kraybill, Katranides M, Margaret A. Coplin, K.s. VirgoAbstract:Abstract The authors previously published details of a method to evaluate the effectiveness of Electronic Message strips in recruiting subjects to a smoking‐cessation program. They now report data suggesting that a shorter, more negative Message yields better results than a longer, more positive Message. The data also show that this approach increases the number of subjects who enroll in a smoking‐cessation program and the number of subjects who actually quit smoking.
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Evaluation of an Electronic Message strip to recruit smokers to a smoking cessation program.
Journal of cancer education : the official journal of the American Association for Cancer Education, 1993Co-Authors: Frank E. Johnson, Janine C. Edwards, Marianne L. Currie, Margaret Katranides, K.s. Virgo, James Daly, Terence P. Wade, William G. KraybillAbstract:Abstract Knowledge of outcome is essential when analyzing effectiveness of educational programs. Although quantitative data can be analyzed more rigorously than other forms of data, quantitation of behavioral processes is often difficult. To promote our smoking‐cessation program we designed a method that relies on Electronic Message strips and a dedicated telephone line capable of providing quantitative outcome information. This approach appears quite versatile and shows that the Electronic Message strip is a surprisingly ineffective method of enlisting subjects into a smoking‐cessation program in our hospital.