SMART Mobile Application Technology Utilization in the Treatment of Sickle Cell Disease Post Day Hospital Discharge



Status:Recruiting
Conditions:Anemia
Therapuetic Areas:Hematology
Healthy:No
Age Range:18 - Any
Updated:11/10/2018
Start Date:July 2015
End Date:August 31, 2019
Contact:Nirmish Shah, MD
Email:nirmish.shah@dm.duke.edu
Phone:919-684-8111

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The purpose of this study is to test a web-aided, mobile-based PHR (Personal Health
Reporting) service to enhance SCD outpatient treatment after discharge from an acute care
setting, such as Duke University Medical Center's Day Hospital. SMART is a new mobile
application created by SickleSoft to increase patient involvement in their treatment and
improve patient to doctor communication. SMART is a self-monitoring and management service
for SCD patients and their treatment doctors. This study will test whether or not use of the
SMART mobile application will help develop the type of patient-doctor relationships that lead
to better health outcomes and a decrease in readmission to an acute care facility.

All patients seen for acute care of painful episodes in our Adult Sickle Cell Day Hospital
will be screened for eligibility. Currently, there are >450 patients actively followed by
staff in our adult Comprehensive Sickle Cell Center, with an average of 60-70 patient day
hospital visits per month.

Intervention and control group. Patients enrolled will be alternately assigned to each group
to ensure randomization and equal numbers of patients to each arm. All patients will be given
a return appointment within 12 days of Day Hospital visit. The control group will get
standard of care, including a printed plan for medications to be taken, phone number to call
for questions or issues, and the return date for visit.

SMART Overview. SMART, a mobile phone-based self-monitoring service to enhance outpatient
treatment in chronic illness will be tested for its utility to help reduce acute care
utilization rates for patients given SMART following acute care visits at the Sickle Cell Day
Hospital. SMART will enable symptom monitoring with a particular emphasis on pain measures,
co-symptoms, and related interventions aided by provider daily monitoring and support guided
by patient report via SMART to provide a Sickle Cell Disease Information interchange (SCDi)
service. Instead of using their current routine of triaging phone messages daily, assessing
patients' need for intervention, providers will instead monitor patients' entries via SMART
daily. Our current clinicians, a nurse practitioner or medical doctor, will review data
generated from patients' reports, as well as patient phone calls. Data entered daily by
patients will be viewable by our clinicians. Rather than only listening to voice mails, a
clinician from our provider team will view an electronic record and communicate with patients
electronically by push notification, text messaging, secure email, or via the app. Our
clinicians may also call patients by telephone, as they would do as necessary when responding
to voice mails. .

Inclusion Criteria:

- documented Hgb SS, SC, or HgbS-beta0 thalassemia

- age 18 years old or older

- seen during an acute care visit at the Duke Day Hospital

Exclusion Criteria:

- incapable of giving informed consent

- greater than 20 acute care visits within the past year

- patients on chronic RBC transfusions (scheduled transfusions)

- patients admitted to the hospital from the day hospital
We found this trial at
1
site
2301 Erwin Rd
Durham, North Carolina 27710
919-684-8111
Duke Univ Med Ctr As a world-class academic and health care system, Duke Medicine strives...
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