Text Messaging, Web-Based Survey System Viable to Recruit Patients with Low Back Pain

Anita Barros Amorim, Ph.D.

Using a text messaging and web-based survey system supplemented by phone calls is a viable method for recruiting patients with low back pain and collecting health outcomes in the emergency department.

The system may reduce costs of using traditional recruitment and data collection methods.

Anita Barros Amorim, Ph.D., and colleagues described the recruitment and response rates using the system. The team recruited participants between July and December 2018 from the emergency departments of four public hospitals in New South Wales, Australia. They invited patients who presented to the emergency departments with nonserious forms of low back pain (nonspecific low back pain, sciatica, and lumbar spinal stenosis) and with a mobile phone number recorded in the medical records.

When eligible patients were discharged from the emergency department, they were informed about the study by clinical staff and/or received a flyer with information about a text message invitation and web-based survey. The local clinical staff obtained patients’ information from the hospital’s electronic health record (EHR). Research staff inserted the information into a secure web app called REDCap.

REDCap was integrated with an automated SMS text messaging system that was used to schedule invitations. Seven days after the emergency department visit at 12:30 p.m., eligible patients received an SMS text message with an invitation and link to answer the web-based survey. The patients received the following text message: ““Dear [name], hope you are going well after your recent visit for back pain to our ED. We are interested in how your back is going and what you thought of our care. Our survey will take only 5 minutes to complete. This survey is being conducted by Dr [name], ED Director of [hospital]. To opt out reply NO -- to begin the survey, visit [link].”

Patients who agreed to participate and completed the week one survey received two follow-up surveys at two and four weeks after presenting at the emergency department. Each participant had up to four opportunities to respond to the web-based survey directly on their smartphone, as reminder messages were sent three times for each data collection if the survey had not been completed.

Overall, 425 patients agreed to participate, and the week one survey was completed by 416 participants. The response rate at week two was 86.5%. At week four, the response rate was 84.4%. In total, 60% of the surveys were completed through SMS text messaging and on the web and 40% were completed via telephone.

Patients who were younger and those from less socioeconomically disadvantaged areas were more likely to respond to the survey through text messaging and the web-based system.

The findings may facilitate recruitment and data collection in clinical trials in emergency departments and potentially reduce the costs of using traditional methods, Amorim and the team concluded.

The study, “Text Messaging and Web-Based Survey System to Recruit Patients With Low Back Pain and Collect Outcomes in the Emergency Department: Observational Study,” was published online in the Journal of Medical Internet Research mHealth and uHealth.