Mobile-health Approach to Gather Clinical Information From Patients Following Hospital Discharge
Condition: Outpatient Parenteral Antibiotic Therapy
Study type: Observational

Summary: 
      The purpose of this study is to assess the feasibility of using a mobile-health approach to
      gather clinical data from patients following discharge from the hospital on outpatient
      parenteral antibiotic therapy (OPAT). The study population will consist of adult participants
      who have a smartphone that is capable of both text messaging and pairing with a Bluetooth
      thermometer that will be provided. Following discharge, patients will be asked to respond to
      two daily text messages. They will also be reminded to take and send in photos of any skin
      rashes that may develop as well as their PICC-line site during dressing changes. Text
      messages will be sent for up to 30 days, but will be stopped sooner if the patient is
      readmitted to the hospital or if OPAT is discontinued. At the end of the 30 days, all
      patients will be sent a text message survey about usability, the time it took to complete the
      study tasks, suggestions for future improvements, and whether they would be willing to be
      interviewed via phone. A subset of the participants will be interviewed via phone to obtain
      more detailed feasibility data. Information from the patient's medical record will be
      collected at the time of hospital discharge as well as at the end of the study period.

      Additionally, a focus group (via conference call) will be conducted with all research team
      members and infectious disease physicians involved in OPAT who did not use the system to
      gauge their needs and to get ideas for future applications of our tools.
    

Detailed description: 
      Following hospital discharge on OPAT, patients will be asked to respond to two daily text
      messages, one in the morning and one in the evening. The message will 1) ask them to take
      their temperature using the provided thermometer, 2) will provide a link to a web-based
      survey that will ask about any symptoms as well as provide a free text response field, and 3)
      remind them to take and send in any photos of any skin rashes that may develop as well as
      their PICC-line site during dressing changes. Text messages will be sent for up to 30 days,
      but will be stopped sooner if the patient is readmitted to the hospital or if OPAT is
      discontinued. At the end of the 30 days, all patients will be sent a text message survey
      about usability, the time it took to complete the study tasks, suggestions for future
      improvements, and whether they would be willing to be interviewed via phone. A subset of the
      participants will be interviewed via phone to obtain more detailed feasibility data.

      Additional information will also be collected from the patient and their medical record at
      the time of hospital discharge (patient caregiver situation, pronouns to address them,
      artificial material in joints or bones, biological sex, race, ethnicity, height, weight, BMI,
      zip code, insurance, reason for OPAT, organisms in cultures, where patient is receiving
      discharge medication, discharge medications, and any other diagnoses/co-morbidities) as well
      as 2 months after enrollment (any readmission dates and reasons, emergency room visit dates
      and reasons, clinic visit dates and reasons, and medication changes within 30 days of
      starting OPAT). These data will be collected 2 months after enrollment to ensure that all
      readmissions, visits, and medication changes are captured in the medical record.

      The software will save time-stamped responses to all web-based surveys, photos sent in, and
      temperatures taken by the thermometer.

      Additionally, a focus group will be conducted (via conference call) with all research team
      members and infectious disease physicians involved in OPAT who did not use the system to
      gauge their needs and to get ideas for future applications of our tools. This conference call
      will be video and audio recorded.

      There will not be any long-term follow up for the study.
    

Intervention name(s): OPAT; Focus Group
Intervention type(s): Other; Other
Intervention description(s): Observation of patients who are discharged from the hospital on OPAT.; Focus group with infectious disease physicians who prescribe OPAT to patients but were not involved in the study.
Observational model: Cohort
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        Patients being discharged from hospital on OPAT.