IText For ICOUGH: Improving Ambulation of Surgical Patients Through Text Messaging

NCT03834428 | Completed

• 1 other identifier: H-38265
• Study Type: interventional
• Target: 37
• Locations: 1 country
• Sites: 1

Brief Summary

The investigators plan to conduct a study that evaluates if text messaging increases patients' adherence to ambulation (specifically reminding patients to get out of bed three or more times daily) which is one component of a protocol called ICOUGH, which is a mnemonic that stands for: Incentive spirometry (a breathing device that expands the lungs), Coughing and deep breathing, Oral hygiene (using a toothbrush for example),Understanding (patient and family education), Getting out of bed at least three times daily, and Head-of-bed elevation to prevent choking; each letter representing steps of a protocol developed at Boston Medical Center (BMC) shown to decrease lung-related complications of surgery. Other outcomes, including frequency of ambulation, pain score, number of visitors per day, head-of-bed elevation, education on importance of ambulation, and falls will also be assessed. The hypothesis is that a reminder text message to ambulate will improve these outcomes over time. While beneficial to patients and health care facilities, the ICOUGH protocol is sometimes both difficult to implement and sustain at an acute care hospital, because: (1) patient motivation fluctuates and is the key determinant of patient ambulation (2) it relies heavily on nurses to both educate patients and then keep them accountable to the protocol, (3) an unfavorable nurse-to-patient ratio, (4) high inpatient turnover for elective surgical cases, and (5) an aging baby boomer population-a higher volume of older, higher- risk patients will require more time and attention per nurse. Therefore, utilization of text message reminders may promote better patient, family, and provider engagement and adherence to ambulation which can improve outcomes and decrease healthcare spending.

Conditions

Ambulation Difficulty

Keywords

Text message reminder; ICOUGH protocol; IText; Safety net hospital; Inpatient

Outcome Measures

Primary Outcomes (1)

• Change in the frequency of ambulation daily while hospitalized

  The frequency of ambulation will be tracked for each participant each day of their hospitalization after ICOUGH education. Ambulation is defined as leaving a patient's room.

  baseline and 10 days

Secondary Outcomes (6)

• Pain Level Scale twice daily while hospitalized

  Twice daily until hospital discharge or for 10 days maximum

• Number of participants that received ambulation education during hospitalization

  At hospital discharge or hospital day #10

• Daily chair usage during hospitalization

  Daily until hospital discharge or for 10 days maximum

• Number of daily visitors while hospitalized

  Daily until hospital discharge or for 10 days maximum

• Number of visitors who helped participants ambulate

  Daily until hospital discharge or for 10 days maximum

Study Arms (2)

No Text Message Control

ACTIVE COMPARATOR

Participants randomized to this arm will receive education about the ICOUGH protocol which includes the importance of ambulation.

Behavioral: ICOUGH protocol

Text Message Intervention

EXPERIMENTAL

Participants randomized to this arm will receive daily text message reminders to ambulate in the hospital in addition to education about the ICOUGH protocol which includes the importance of ambulation.

Behavioral: Text Message Intervention; Behavioral: ICOUGH protocol

Interventions

Text Message Intervention BEHAVIORAL

A text message will be sent once daily (between noon and 3p) to remind participants to ambulate at least 3 times each day while hospitalized.

Text Message Intervention

ICOUGH protocol BEHAVIORAL

Education will be provided about the ICOUGH protocol which includes: Incentive spirometry (a breathing device that expands the lungs), Coughing and deep breathing, Oral hygiene (for example using a toothbrush), Understanding (patient and family education), Getting out of bed at least three times daily, and Head-of-bed elevation to prevent choking.

No Text Message Control; Text Message Intervention

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Patients of all genders on any surgical service at Boston Medical Center
• English speaking
• Ability to read at 5th grade level
• Able to ambulate, with or without assistance
• Possession of a personal cell phone that can receive text messages

You may not qualify if:

• Visually impaired or blind
• Presence of neuromuscular disease or inability to perform all the measures in the ICOUGH protocol
• Prisoners
• Pregnant women

Sponsors & Collaborators

• Boston Medical Center: lead

Study Sites (1)

Boston Medical Center

Boston, Massachusetts, 02118, United States

Location

MeSH Terms

Conditions

Mobility Limitation

Condition Hierarchy (Ancestors)

Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Study Officials

• Pamela Rosenkranz

  Boston University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: February 5, 2019
• First Posted: February 8, 2019
• Study Start: March 21, 2019
• Primary Completion: June 7, 2019
• Study Completion: July 13, 2019
• Last Updated: July 16, 2019

Record last verified: 2019-07

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)