Wolff Margaret, Balamuth Fran, Sampayo Esther, Mollen Cynthia
Departments of Pediatrics and Emergency Medicine, University of Michigan, Ann Arbor, MI.
Children's Hospital of Philadelphia, Division of Emergency Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA.
Ann Emerg Med. 2016 May;67(5):602-609.e3. doi: 10.1016/j.annemergmed.2015.10.022. Epub 2015 Dec 11.
Centers for Disease Control and Prevention guidelines recommend follow-up within 72 hours of diagnosis of pelvic inflammatory disease because patients with inadequate treatment are at increased risk of acute and chronic complications. Follow-up rates in adolescents after diagnosis range between 10% and 16%. The primary objective is to assess the effect of text message reminders to adolescent patients receiving a diagnosis of pelvic inflammatory disease on obtaining follow-up care within 72 hours of emergency department (ED) discharge.
This was a single-blinded randomized controlled trial of adolescents receiving a diagnosis of pelvic inflammatory disease in the ED. Patients received standard discharge instructions or standard discharge instructions plus text message reminders. Patients in the text message group received daily, tailored text messages for 4 days, with a reminder to schedule and attend primary care provider follow-up. The primary outcome was follow-up within 72 hours of ED discharge.
Ninety-five patients (48 standard; 47 text message) were randomized. Three patients were excluded, leaving 92 patients (46 standard; 46 text message) for analysis. Baseline characteristics were similar between treatment groups. Follow-up was 15.2% in the standard group and 43.5% in the text message group. Patients receiving text message reminders were more likely to follow up compared with the standard group (relative risk 2.9; 95% confidence interval [CI] 1.4 to 5.7). The absolute efficacy difference was 28.3% (95% CI 9.5% to 46.9%), yielding number needed to treat of 4 (95% CI 2.2 to 9.5).
Personalized text message reminders were efficacious in improving follow-up for adolescents after ED diagnosis of pelvic inflammatory disease.
美国疾病控制与预防中心的指南建议在盆腔炎诊断后72小时内进行随访，因为治疗不充分的患者发生急慢性并发症的风险会增加。青少年盆腔炎诊断后的随访率在10%至16%之间。主要目的是评估向诊断为盆腔炎的青少年患者发送短信提醒对其在急诊科（ED）出院后72小时内获得后续护理的影响。
这是一项针对在急诊科被诊断为盆腔炎的青少年的单盲随机对照试验。患者接受标准出院指导或标准出院指导加短信提醒。短信组的患者连续4天每天收到量身定制的短信，提醒他们安排并前往初级保健提供者处进行随访。主要结局是ED出院后72小时内的随访情况。
95名患者（48名标准组；47名短信组）被随机分组。3名患者被排除，剩余92名患者（46名标准组；46名短信组）进行分析。各治疗组的基线特征相似。标准组的随访率为15.2%，短信组为43.5%。与标准组相比，收到短信提醒的患者更有可能进行随访（相对风险2.9；95%置信区间[CI]1.4至5.7）。绝对疗效差异为28.3%（95%CI 9.5%至46.9%），治疗所需人数为4（95%CI 2.2至9.5）。
个性化短信提醒有助于提高青少年在急诊科诊断盆腔炎后的随访率。
