Summary

This study validated administration of hip specific outcome instruments (HOOS-PAIN, HOOS-PS) over a mobile phone based text messaging platform delivered outside of a clinical encounter, with a >94% completion rate among hip preservation patients.

Abstract

Background

Validated patient reported outcome (PRO) instruments are an essential component of value-based healthcare. Current PRO completion formats are limited by the need for paper or computer interfaces and in office visits. The purpose of the present study was to evaluate the efficacy of administration of hip specific outcome instruments over a mobile phone based text messaging platform delivered outside of a clinical encounter.

Methods

Consecutive patients (n=72) presenting to a Hip Preservation Clinic for evaluation of hip pain were enrolled. Subjects completed the Hip disability and Osteoarthritis Outcome Score Short Form physical function and Pain subscales (HOOS-PS, HOOS-PAIN) via a hand-held tablet. The subsequent day, patients were asked to complete the same PRO instruments via a custom-built text messaging software program. Automated reminders were sent to patients to encourage completion of unanswered questions. Correlation between in-office and mobile phone delivery of the PROs were assessed. We defined excellent reproducibility to be an intraclass correlation coefficient (ICC) of >0.75. Demographic data including age, gender, and diagnosis were retrospectively collected.

Results

There was a 94% (64/69) completion rate for patients who received the outcome instrument questionnaire over text messaging. The mean age was 31±10.5 years (range 15-55) and 70% of respondents were female. The ICC between in-office electronic and at-home mobile phone delivery of HOOS-PS was 0.72 (95% confidence interval [CI] 0.58-0.81) and HOOS-Pain was 0.80 (95% CI 0.69-0.87). Cell phone scores were lower than in-office scores by an average 8.7±12.6 and 7.5±12.1 points for HOOS-PS and HOOS-Pain, respectively. Patients most frequently requested morning communication between 8AM-Noon (65%) to afternoon communication 4-8PM (35%).

Conclusion

HOOS-PS and HOOS-Pain PRO instruments administered via mobile phone text messaging demonstrates good to excellent reproducibility and an equal completion rate compared to traditional in office methods. Mobile phone delivery utilizing our software algorithms may be a valid method for administration of other PROs in this population and both eliminates in-office testing, allowing communication with patients anytime and anywhere.