Sanguansak Thuss, Morley Katharine E, Morley Michael G, Thinkhamrop Kavin, Thuanman Jaruwan, Agarwal Isha
Department of Ophthalmology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
Department of Medicine, Massachusetts General Hospital, Boston, MA, United States.
J Med Internet Res. 2017 Dec 19;19(12):e413. doi: 10.2196/jmir.8330.
Social media offers a new way to provide education, reminders, and support for patients with a variety of health conditions. Most of these interventions use one-way, provider-patient communication. Incorporating social media tools to improve postoperative (postop) education and follow-up care has only been used in limited situations.
The aim of this study was to determine the feasibility and efficacy of two-way social media messaging to deliver reminders and educational information about postop care to cataract patients.
A total of 98 patients undergoing their first eye cataract surgery were divided into two groups: a no message group receiving usual pre- and postop care and a message group receiving usual care plus messages in a mobile social media format with standardized content and timing. Each patient in the message group received nine messages about hand and face hygiene, medication and postop visit adherence, and links to patient education videos about postop care. Patients could respond to messages as desired. Main outcome measures included medication adherence, postop visit adherence, clinical outcomes, and patients' subjective assessments of two-way messaging. The number, types, content, and timing of responses by patients to messages were recorded.
Medication adherence was better in the message group at postop day 7, with high adherence in 47 patients (96%, 47/49) versus 36 patients (73%, 36/49) in the no message group (P=.004), but no statistically significant differences in medication adherence between the groups were noted at preop and postop day 30. Visit adherence was higher at postop day 30 in the message group (100%, 49/49) versus the no message group (88%, 43/49; P=.03) but was 100% (49/49) in both groups at postop day 1 and 7. Final visual outcomes were similar between groups. A total of 441 standardized messages were sent to the message group. Out of 270 responses generated, 188 (70%) were simple acknowledgments or "thank you," and 82 (30%) responses were questions that were divided into three general categories: administrative, postop care, and clinical issues. Out of the 82 question responses, 31 (11%) were about administrative issues, 28 (10%) about postop care, and 23 (9%) about clinical symptoms. All the messages about symptoms were triaged by nurses or ophthalmologists and only required reassurance or information. Patients expressed satisfaction with messaging.
Two-way social media messaging to deliver postop information to cataract patients is feasible and improves early medication compliance. Further design improvements can streamline work flow to optimize efficiency and patient satisfaction.
社交媒体为向患有各种健康状况的患者提供教育、提醒和支持提供了一种新方式。这些干预措施大多采用单向的医患沟通方式。将社交媒体工具用于改善术后教育和后续护理仅在有限的情况下被使用。
本研究的目的是确定通过双向社交媒体消息传递向白内障患者提供术后护理提醒和教育信息的可行性和有效性。
总共98例接受首次白内障手术的患者被分为两组：无消息组接受常规的术前和术后护理，消息组接受常规护理并加上以移动社交媒体形式发送的具有标准化内容和时间安排的消息。消息组中的每位患者收到九条关于手部和面部卫生、药物治疗和术后就诊依从性的消息，以及指向术后护理患者教育视频的链接。患者可以根据需要回复消息。主要结局指标包括药物依从性、术后就诊依从性、临床结局以及患者对双向消息传递的主观评估。记录患者对消息的回复数量、类型、内容和时间。
在术后第7天，消息组的药物依从性更好，47例患者（96%，47/49）依从性高，而无消息组为36例患者（73%，36/49）（P = 0.004），但在术前和术后第30天，两组之间的药物依从性无统计学显著差异。在术后第30天，消息组的就诊依从性高于无消息组（100%，49/49）对（88%，43/49；P = 0.03），但在术后第1天和第7天，两组的就诊依从性均为100%（49/49）。两组的最终视力结局相似。总共向消息组发送了441条标准化消息。在产生的270条回复中，188条（70%）是简单确认或“谢谢”，82条（30%）回复是问题，分为三大类：管理问题、术后护理问题和临床问题。在82条问题回复中，31条（11%）是关于管理问题，28条（10%）是关于术后护理问题，23条（9%）是关于临床症状的问题。所有关于症状的消息均由护士或眼科医生进行分类处理，仅需要安慰或提供信息。患者对消息传递表示满意。
通过双向社交媒体消息传递向白内障患者提供术后信息是可行的，并能提高早期药物依从性。进一步的设计改进可以简化工作流程，以优化效率和患者满意度。
