Patient Navigator Facilitated Text Messaging Intervention Improves Linkage to care in Viral Hepatitis B: A Pilot Study

Abstract

Background: Despite the high prevalence of chronic hepatitis B (CHB) in Asian Americans and other ethnic groups, a majority of these populations remains unscreened and unprotected. A large percentage of those who are chronically infected with hepatitis B virus (HBV) are not linked to care owing to a poor health care access. The purpose of this study was to evaluate the use of mobile text messaging in engaging individuals with hepatitis B or at risk for it, and to assess their acceptance of text messaging interventions. Materials and Methods:A total of 32 individuals who were either chronically infected with HBV or non-immune to HBV were assigned to a patient navigator (PN), who subsequently arranged for the subjects to communicate through text messaging. The frequency and contents of messages between the subjects and the PN were evaluated. After the three month intervention period, results on linkage to care (LTC) were obtained. A self-report questionnaire was employed to assess the subjects' feedback on the use of text messaging.Results: All of 32 participants responded to the PNs with either text messaging or phone calls. The most frequent message themes were finding doctors and appointment reminders. Fourteen of 16 HBV infected subjects were linked to physicians, and all of 16 non-immune subjects received one or two vaccinations. The survey revealed strong receptivity to and acceptance of the use of text messaging.Conclusions: Mobile text messaging intervention provides a platform for patients to engage with medical personnel, thereby improving their access to healthcare.

Efficacy of a Mobile Texting App (HepTalk) in Encouraging Patient Participation in Viral Hepatitis B Care: Development and Cohort Study

“…The results of this study demonstrate that HepTalk can be employed to boost patient engagement and improve outcomes in hepatitis B care. This study further supports the finding of our previous study, which suggested that a form of mobile texting combined with the patient navigator program facilitated communication between the patients and HCPs and enhanced LTC [14]. HepTalk provided an effective communication mechanism through which patient navigators were able to guide participants to appropriate health care resources.…”

“…However, it may be premature to consider these participants linked because some of these linked participants may not return to HCPs for follow-up in the future. Thus, although the texting intervention was significantly longer in this study compared with the intervention period employed in our previous study [14], studies with an intervention period greater than 6 months may be preferable to assess the sustainability of the efficacy of the HepTalk communication. This is particularly important because we have noted that a small but significant portion of CHB patients with long histories of infection saw HCPs once but did not sustain their LTC.…”

“…We have previously investigated the use of mobile text messaging in facilitating the connection between HCPs and individuals with CHB or at risk for it [14]. In this pilot study involving 32 participants, the frequency and contents of the messages between participants and patient navigators were evaluated.…”