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Kapoor A, Patel P, Chennupati S, Mbusa D, Sadiq H, Rampam S, Leung R, Miller M, Vargas KR, Fry P, Lowe MM, Catalano C, Harrison C, Catanzaro J, Crawford S, Smith AM
Comparing the Efficacy of Targeted and Blast Portal Messaging in Message Opening Rate and Anticoagulation Initiation in Patients With Atrial Fibrillation in the Preventing Preventable Strokes Study II: Prospective Cohort Study
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Targeted Superior to Blast Portal Messaging in Message Opening Rate and Anticoagulation (AC) Initiation in Patients with Atrial Fibrillation in Preventing Preventable Strokes Study II: Prospective Cohort Study
Alok Kapoor;
Parth Patel;
Soumya Chennupati;
Daniel Mbusa;
Hammad Sadiq;
Sanjeev Rampam;
Robert Leung;
Megan Miller;
Kevin Rivera Vargas;
Patrick Fry;
Mary Martin Lowe;
Christina Catalano;
Charles Harrison;
John Catanzaro;
Sybil Crawford;
Anne Marie Smith
ABSTRACT
Background:
The gap in anticoagulation (AC) use among patients with atrial fibrillation (AF) is a major public health threat. Inadequate patient education contributes to this gap. Patient portal-based messaging linked to educational materials may help close this gap but the best messaging approach is unknown.
Objective:
To compare responsiveness of patients to two portal messaging approaches at two different health systems: targeted messaging 1 week before outpatient appointment vs. sending messages all in one blast.
Methods:
Using the two approaches, we sent messages to high risk patients on and off AC as well as those at low risk who may become eligible for AC in the future (where risk was classified based on CHA2DS2-VASC score). The messages contained a link to Upbeat.org, a website of the Heart Rhythm Society which has print and video materials about AF and AC. We then tracked message opening, review of the website, and AC use across messaging approaches/sites adjusting for potential confounders.
Results:
We sent 1672 targeted messages and 1450 blast messages. Message opening was significantly higher with the targeted approach for patients on AC (64% versus 57% p value 0.005) and trended the same in patients off AC; subsequent website review was not different by messaging approach. More patients off AC at baseline started AC with the targeted approach (adjusted percentage 9.3% vs. 2.1% p < 0.001).
Conclusions:
Patients were more responsive in terms of message opening and subsequent AC initiation with the targeted approach. Non-random allocation of the intervention limits firm conclusions.
Citation
Please cite as:
Kapoor A, Patel P, Chennupati S, Mbusa D, Sadiq H, Rampam S, Leung R, Miller M, Vargas KR, Fry P, Lowe MM, Catalano C, Harrison C, Catanzaro J, Crawford S, Smith AM
Comparing the Efficacy of Targeted and Blast Portal Messaging in Message Opening Rate and Anticoagulation Initiation in Patients With Atrial Fibrillation in the Preventing Preventable Strokes Study II: Prospective Cohort Study