Efficacy of Short Message Service Text Messaging Interventions for Postoperative Pain Management: Systematic Review

Abstract

Background Addiction to opiates and synthetic opioids poses a major threat to public health worldwide, with pharmaceutical opioids prescribed to manage pain constituting the main problem. To counteract this threat, suitable pain management strategies should be implemented in health care. Monitoring pain management seems to be feasible using telemedicine with a certain degree of resource intensity and digitization. As a communication channel for this type of monitoring, SMS appears to be a valid alternative. Objective The aim of this systematic literature review was to (1) provide information on the state of research regarding postoperative pain management via SMS, (2) establish a basic understanding of SMS-based pain management, and (3) provide insight into the feasibility of these management strategies. The research question was as follows: Is postoperative pain management feasible and effective utilizing SMS? Methods A systematic literature review was performed mainly following the PRISMA guidelines and another guide on performing a systematic literature review for information systems–related research. A search string was developed based on the objectives and research question, and eight databases were searched. Results The initial search resulted in 2083 records, which could be narrowed down by applying various exclusion criteria. Thereby, 11 articles were identified as relevant, which were accordingly analyzed and evaluated by full-text screening. In all articles, pain management interventions were performed using SMS communication between health care professionals and patients or their legal guardians. A prospective approach was predominantly chosen as the study design (91%) with the leading research objective of determining the intervention’s feasibility (73%). The primary reason for sending SMS messages was to monitor patients (64%). Overall, the use of SMS improved adherence, acceptance, and satisfaction regarding postoperative pain management. With an average response rate of approximately 89.5% (SD 3.8%), the reliability of SMS as a communication and monitoring tool was further emphasized. This response rate is significantly higher than that for email interventions (66.63%, P<.001). Conclusions This study provides a comprehensive picture of the current status on postoperative pain management by SMS. Communication via SMS was beneficial in all interventions, even preoperative. Six SMS interventions could be certified by the respective institutional review board and three were Health Insurance Portability and Accountability Act–compliant. Therefore, the results of this study could be leveraged to address the opioid epidemic. Overall, the research question could be confirmed. Future research should extend this systematic literature review regarding preoperative pain management. Based on these findings, a pre- and postoperative communication model should be developed to address the opioid epidemic effectively.

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“…The overall findings reveal that SMS-based perioperative communication is acceptable, efficient, and effective for patients, caregivers, and health care providers. Furthermore, the interventions demonstrate positive results, including reduced anxiety, increased adherence to treatment, improved symptom monitoring, better pain management, increased satisfaction with care, and lower postoperative readmission rates [ 26 , 27 ]. Importantly, they also provide continuity of care in the preoperative-to-postoperative window [ 11 , 29 - 31 ].…”

A digital health intervention to support patients with chronic pain during prescription opioid tapering: a pilot randomised controlled trial

“…Recent systematic reviews of text message–based interventions for pain do not report evidence of adverse events. 10 , 24 However, lack of reported adverse events may be underestimated due to lack of monitoring, 24 , 27 which is a common limitation of studies on psychological treatments for chronic pain. 16 Accordingly, in subsequent trials, 27 we will use the Negative Effects Questionnaire 53 and interview participants to investigate the incidence of a wide range of unwanted events and whether they are attributed to the intervention received.…”

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“…In terms of frequency, most participants (143/216, 66.2%) found the frequency of the mobile phone SMS text message program to be about right, with approximately one-third (70/216, 32.4%) reporting that they were too frequent, especially in the first 2 weeks, when they received 2 a day. This is a common issue in SMS text message interventions [ 28 , 29 ] and may differ depending on individual preferences. Similarly, some participants (14/216, 6.5%) reported blocking the messages because of their frequency.…”