Educational text messaging for pressure ulcer prevention in people living with spinal cord injury who are newly discharged from hospital: A pilot study protocol

Introduction: Pressure ulcer (PU) represents a significant health, social and economic burden for patients with spinal cord injury (SCI). Prevention of PU by better education and pressure-relief exercises may reduce the risk of development but compliance can be low. Lack of knowledge of skin care after the discharge and loss of motivation to adhere pressure-relief regimen have been reported by SCI individuals1. Educational text message have been shown to induce behavioural changes and improve adherence in other clinical situations2. Hence we sought to conduct a pilot study introducing the early intervention by sending text messaging for PU prevention in SCI.
Method: Participants who are newly discharged from SCI unit will be randomly assigned to either Intervention group or control group. Participants in Intervention group will receive a text message reminder two times a week for six months. Control group will receive standard following-up care without no text message. Primary outcomes: concordance with ‘pressure-relief’ regimen. Participants will complete a ‘pressure-relief’ questionnaire at baseline. 3 and 6 months; incidence of pressure ulcer I-IV). Secondary outcomes: .acceptability, satisfactory of the early interventions. Participants in intervention group will be asked to fill a questionnaire at end of the study.
Results: This study has been registered NIHR portfolio research database (NIHR Central Portfolio Management System (CPMS) and registered as a clinical trial withTrial ID: ISRCTN38320572. A total of eleven patients were recruited by May 2018, six of them were randomly allocated to ‘text message’ group, one participant deceased at 2-month post-discharge. Five participants were assigned to ‘control group’. All of them have completed baseline questionnaire, three participants have completed 3-month questionnaire. Final analysis will be reported after full recruitment.
Conclusion/Discussion: To our knowledge, this will be the first study to explore the efficacy and feasibility of text messaging to promote ‘pressure relief’ using concordance questionnaire for individuals with SCI. This pilot study is conducted to assist in the development of methods of early education and outcome measure. If the study suggests potential efficacy, then this would justify larger trials to test effectiveness and implementing early intervention for tackling the PU in people living with SCI
References:
1.Liu LQ et al Concordance to ‘Pressure-relief’ regimen for pressure ulcer (PrU) prevention in spinal cord injury (SCI). The 55th ISCoS Annual Scientific Meeting 2017
2. Finitsis DJ et al Intervention Designs to Promote Adherence to Antiretroviral Therapy (ART): A Meta-Analysis of Randomized Controlled Trials. PLoS One. 2014 5;9(2):e88166