Research tools used in the TXT4FLUJAB randomised controlled trial. These include a study protocol, patient questionnaire, practice questionnaire and instructions for its implementation

Chadborn, Tim

Free, Caroline

Goldacre, Ben

Herrett, Emily

Ranopa, Michael

Smeeth, Liam

van Staa, Tjeerd

Williamson, Elizabeth

BMJ Open

PubMed

Name not available

Text messaging reminders for influenza vaccine in primary care: a cluster randomised controlled trial (TXT4FLUJAB)

OBJECTIVES: (1) To develop methods for conducting cluster randomised trials of text messaging interventions utilising routine electronic health records at low cost; (2) to assess the effectiveness of text messaging influenza vaccine reminders in increasing vaccine uptake in patients with chronic conditions. DESIGN: Cluster randomised trial with general practices as clusters. SETTING: English primary care. PARTICIPANTS: 156 general practices, who used text messaging software, who had not previously used text message influenza vaccination reminders. Eligible patients were aged 18-64 in 'at-risk' groups. INTERVENTIONS: Practices were randomly allocated to either an intervention or standard care arm in the 2013 influenza season (September to December). Practices in the intervention arm were asked to send a text message influenza vaccination reminder to their at-risk patients under 65. Practices in the standard care arm were asked to continue their influenza campaign as planned. BLINDING: Practices were not blinded. Analysis was performed blinded to practice allocation. MAIN OUTCOME MEASURES: Practice-level influenza vaccine uptake among at-risk patients aged 18-64 years. RESULTS: 77 practices were randomised to the intervention group (76 analysed, n at-risk patients=51,121), 79 to the standard care group (79 analysed, n at-risk patients=51,136). The text message increased absolute vaccine uptake by 2.62% (95% CI -0.09% to 5.33%), p=0.058, though this could have been due to chance. Within intervention clusters, a median 21.0% (IQR 10.2% to 47.0%) of eligible patients were sent a text message. The number needed to treat was 7.0 (95% CI -0.29 to 14.3). CONCLUSIONS: Patient follow-up using routine electronic health records is a low cost method of conducting cluster randomised trials. Text messaging reminders are likely to result in modest improvements in influenza vaccine uptake, but levels of patients being texted need to markedly increase if text messaging reminders are to have much effect. TRIAL REGISTRATION NUMBER: ISRCTN48840025

LSHTM Research Online

Text messaging reminders for influenza vaccine in primary care: a cluster randomised controlled trial (TXT4FLUJAB).

LSHTM Data Compass

  TEXT4FLUJAB Instructions for practices  You have been assigned to the intervention group, and therefore you should send a text message to patients that are aged under 65 in a clinical risk group.  This is the group that you would normally target for your seasonal flu campaign and includes patients who are under 65 with:  Diabetes;  Chronic heart disease;  Chronic neurological disease;  Chronic kidney disease;  Chronic respiratory disease;  Immunosuppression; or  Chronic liver disease. You should use your practice computer system to identify these patients in the usual way.   You should also still proceed with any other strategies that you had planned to contact patients about flu vaccine. The text message should be sent at the beginning of your seasonal flu campaign and the content should be as follows: “Hello PATIENT NAME, to reduce your risk of serious health problems from flu we recommend vaccination. Call PRACTICE PHONE NUMBER to book. PRACTICE NAME” The text messaging software has options to insert the name of the patient, your practice telephone number and your practice name.    A step-by-step guide has been included in this information pack to help you send the message.  If you are having any problems with the text messaging software, then please contact IPLATO by emailing: support@iplato.net or calling: 020 3178 4675.  Please note that your practice will be charged at an hourly rate for calls longer than 15 minutes. If you have any other questions about the trial, then call Emily Herrett on 0207 927 2837.   TXT4FLUJAB : 3 Step Guide Introduction The TXT4FLUJAB trial seeks to target one patient cohort: people under 65 who live with chronic condition(s).   To send your test message, there are 3 steps to complete; together this should take no longer than 15 min. If, at any stage, you need any assistance please email support@iplato.net to book a phone appointment with an iPLATO support consultant.      Search • Surgery runs searches on their GP system for at risk patients eligible for flu jab and uploads list of patients into a group in iPLATO Patient Care Messaging. Send • Surgery sends message to at-risk patients inviting them to receive a flu jab. Book • Surgery books patient in for appointment and ensures that the patient turns up.     Step 1- Search 1) Search GP system:   On your GP system (Emis, Vision, iSoft, TPP SystemOne) run searches for the required cohort.  Export the search as an Excel spreadsheet or CSV file containing the patient’s unique ID number.  Open the file from its saved location. Please call your GP Systems provider for help on running these searches.  2) Import search into iPLATO: Perform the steps below.  Log in to: http://www.pcm.nhs.uk with your user name and password.  Create your group: a. Click on ‘PHONEBOOK’ Menu.  b. Click on the ‘Groups’ button.  c. Click on the ‘Add New’ button and in Group Name box enter your patient group name e.g. Seasonal Flu 16-64 at Risk and select ‘Save’.  d. Once saved, a pop up window will appear on screen called ‘Edit Group’. e. Open the saved search (Excel spread sheet or CSV file) from its saved location (see step 1 above). f. Highlight and Copy the ‘Patient ID’ column in the search (right click and select copy).    g. Paste the column  into the ‘Patient ID’ box in the ‘Edit Group’ window.  h. Patient IDs will now appear in the patient ID box, click on the ‘blue arrow’ to move the Patient IDs into the member box. i. Once all of your patients have moved across to the members box click on ‘Save’. You have created your group!       Step 2 – Send Patients respond quickly to SMS sent from their GP so please brief your reception staff in advance of sending in the event that the campaign might generate increased volumes of patients calling in to the surgery.  You may wish to stagger the message over a few days to spread the workload, and send the messages on a quiet day or quiet time of day.  Message Templates Before sending a message to relevant patients please ensure that you use the wording of the template message below.  You can create a template of this message through the ‘Manage Templates’ function.  Template Hello <firstname2>, to reduce your risk of serious health problems from flu we recommend vaccination. Call <INSERT PRACTICE PHONE NUMBER> to book. <INSERT PRACTICE NAME>  Sending 1. Click on ‘TEXT Menu’:  2. Select recipients:  Scroll down to the Groups box on the left hand side and highlight your first patient group.   Click on the ‘blue arrow’ to move the group across to the recipient list i.e. Seasonal Flu 16-65 at risk.   Press the ‘Next’ button to bring you to the next sub menu ‘Message’.      3. Select your text message:   Scroll down to the Templates box and Highlight your flu message. Click on the ‘blue arrow’ to move it to the message box.     Press the ‘Next’ button to go to the next page ‘Sending Options’. 4. Add a Read Code (Optional):  Click the ‘Add’ a Read Code button (feature not available if you are sending SMS through NHSmail OR you use iSOFT or TPP SystemOne).   Click on the button under sending option at the bottom left of the screen.  In the box labelled ‘Read Code’ enter 9OXC1 for Flu Vaccination invite first SMS text message sent and click on ‘Save’.   Alternatively enter any Read Code you consider appropriate. You can also add your own customised comment that will be added to the Patient Read Code in the patient record.  5. Review your message and Send:  Click on the ‘Confirm to Send’ button on the bottom right of the screen and check that all message details are correct. - Check the message template is correct. - Check number of recipients selected is correct. - If you wish to change any details, click on ‘Cancel’ button. - Click the ‘Send’ button       Step 3 – Book Patient Responses In the event that patients reply to the message, the message will be forwarded by email to the practice manager or administrator (as per system settings).  E-mail inboxes should be checked regularly for patient responses. Alternatively go to Reports Menu 4 > Inbox for a list of all patient responses. Please ensure that you brief reception prior to sending. Patients respond quickly so, if you ask them in your flu message template to call in to book an appointment, you need to be prepared.  There is no cost to the practice however the patients’ mobile network provider will charge the patient at the operators’ standard rate.     7     

Text messaging reminders for influenza vaccine in primary care: a cluster randomised controlled trial (TXT4FLUJAB)

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