Recruitment of trial participants through electronic medical record patient portal messaging: A pilot study

Timothy B. Plante, Kelly T. Gleason, Hailey N. Miller, Jeanne Charleston, Kristen McArthur, Cheryl Dennison Himmelfarb, Mariana Lazo, Daniel E. Ford, Edgar R. Miller, Lawrence J. Appel, Stephen P. Juraschek, Nicole Cronin, Scott McClure, Jennifer Miskimon, Christine M. Mitchell, Rita R. Kalyani, David L. Roth, Jennifer A. Schrack, Sarah L. Szanton, Jacek UrbanekJeremy Walston, Amal Wanigatunga, Sheriza N. Baksh, Amanda L. Blackford, Shumon Chattopadhyay, Lea T. Drye, John Dodge, Cathleen Ewing, Sana Haider, Stephanie C. Holland, Rosetta Jackson, Andrea Lears, Curtis Meinert, David Shade, Michael Smith, Alice L. Sternberg, James Tonascia, Mark L. Van Natta, Annette Wagoner, George W. Comstock, Erin D. Michos, J. Denise Bennett, Pamela Bowers, Josef Coresh, Patricia Crowley, Tammy Crunkleton, Briana Dick, Rebecca Evans, Mary Godwin, Lynne Hammann, Deborah Hawks, Karen Horning, Erika Hull, Brandi Mills, Melissa Minotti, Leann Raley, Amanda Reed, Rhonda Reeder, Cassie Reid, Melissa Shuda, Adria Spikes, Rhonda Stouffer, Kelly Weicht, Caroline Abbas, Bernellyn Carey, Syree Davis, Naomi DeRoche-Brown, Debra Gayles, Sherlina Holland, Ina Glenn-Smith, Duane Johnson, Mia Johnson, Eva Keyes, Danielle Santiago, Chanchai Sapun, Valerie Sneed, Lee Swartz, Letitia Thomas, Robert H. Christenson, Show Hong Duh, Heather Rebuck, Clifford Rosen, Tom Cook, Pamela Duncan, Karen Hansen, Anne Kenny, Sue Shapses, Judy Hannah, Sergei Romashkan, Cindy D. Davis, Christopher T. Sempos, Jack M. Guralnik, J. C. Gallagher

Research output: Contribution to journalArticle

Abstract

Background/aim: Cost-efficient methods are essential for successful participant recruitment in clinical trials. Patient portal messages are an emerging means of recruiting potentially eligible patients into trials. We assessed the response rate and complaint rate from direct-to-patient, targeted recruitment through patient portals of an electronic medical record for a clinical trial, and compared response rates by differences in message content. Methods: The Study to Understand Fall Reduction and Vitamin D in You (STURDY) trial is a National Institutes of Health–sponsored, community-based study of vitamin D supplementation for fall prevention in older adults conducted at Johns Hopkins. Potential participants were identified using the Epic electronic medical record at the Johns Hopkins Health System based on age (≥70 years), ZIP code (30-mile radius of study site), and prior activation of a patient portal account. We prepared a shorter message and a longer message. Both had basic information about study participation, but the longer message also contained information about the significance of the study and a personal invitation from the STURDY principal investigator. The Hopkins Institutional Review Board did not require prior consent from the patient or their providers. We calculated the response rate and tracked the number of complaints and requests for removal from future messages. We also determined response rate according to message content. Results: Of the 5.5 million individuals receiving care at the Johns Hopkins Health System, a sample of 6896 met our inclusion criteria and were sent one patient portal recruitment message between 6 April 2017 and 3 August 2017. Assessment of enrollment by this method ended on 1 December 2017. There were 116 patients who expressed interest in the study (response rate: 1.7%). Twelve (0.2%) recipients were randomized. There were two complaints (0.03%) and one request to unsubscribe from future recruitment messages (0.01%). Response rate was higher with the longer message than the shorter message (2.1% vs 1.2%; p = 0.005). Conclusion: Patient portal messages inviting seniors to participate in a randomized controlled trial resulted in a response rate similar to commercial email marketing and resulted in very few complaints or opt-out requests. Furthermore, a longer message with more content enhanced response rate. Recruitment through patient portals might be an effective strategy to enroll trial participants.

Original languageEnglish (US)
JournalClinical Trials
DOIs
StateAccepted/In press - Jan 1 2019

Fingerprint

Electronic Health Records
Vitamin D
Patient Selection
Clinical Trials
Research Ethics Committees
Health
Marketing
Patient Portals
Randomized Controlled Trials
Research Personnel
Costs and Cost Analysis

Keywords

  • Clinical trial
  • electronic medical records
  • patient portal messages
  • randomized controlled trial
  • recruitment methods

ASJC Scopus subject areas

  • Pharmacology

Cite this

Recruitment of trial participants through electronic medical record patient portal messaging : A pilot study. / Plante, Timothy B.; Gleason, Kelly T.; Miller, Hailey N.; Charleston, Jeanne; McArthur, Kristen; Himmelfarb, Cheryl Dennison; Lazo, Mariana; Ford, Daniel E.; Miller, Edgar R.; Appel, Lawrence J.; Juraschek, Stephen P.; Cronin, Nicole; McClure, Scott; Miskimon, Jennifer; Mitchell, Christine M.; Kalyani, Rita R.; Roth, David L.; Schrack, Jennifer A.; Szanton, Sarah L.; Urbanek, Jacek; Walston, Jeremy; Wanigatunga, Amal; Baksh, Sheriza N.; Blackford, Amanda L.; Chattopadhyay, Shumon; Drye, Lea T.; Dodge, John; Ewing, Cathleen; Haider, Sana; Holland, Stephanie C.; Jackson, Rosetta; Lears, Andrea; Meinert, Curtis; Shade, David; Smith, Michael; Sternberg, Alice L.; Tonascia, James; Van Natta, Mark L.; Wagoner, Annette; Comstock, George W.; Michos, Erin D.; Bennett, J. Denise; Bowers, Pamela; Coresh, Josef; Crowley, Patricia; Crunkleton, Tammy; Dick, Briana; Evans, Rebecca; Godwin, Mary; Hammann, Lynne; Hawks, Deborah; Horning, Karen; Hull, Erika; Mills, Brandi; Minotti, Melissa; Raley, Leann; Reed, Amanda; Reeder, Rhonda; Reid, Cassie; Shuda, Melissa; Spikes, Adria; Stouffer, Rhonda; Weicht, Kelly; Abbas, Caroline; Carey, Bernellyn; Davis, Syree; DeRoche-Brown, Naomi; Gayles, Debra; Holland, Sherlina; Glenn-Smith, Ina; Johnson, Duane; Johnson, Mia; Keyes, Eva; Santiago, Danielle; Sapun, Chanchai; Sneed, Valerie; Swartz, Lee; Thomas, Letitia; Christenson, Robert H.; Duh, Show Hong; Rebuck, Heather; Rosen, Clifford; Cook, Tom; Duncan, Pamela; Hansen, Karen; Kenny, Anne; Shapses, Sue; Hannah, Judy; Romashkan, Sergei; Davis, Cindy D.; Sempos, Christopher T.; Guralnik, Jack M.; Gallagher, J. C.

In: Clinical Trials, 01.01.2019.

Research output: Contribution to journalArticle

Plante, TB, Gleason, KT, Miller, HN, Charleston, J, McArthur, K, Himmelfarb, CD, Lazo, M, Ford, DE, Miller, ER, Appel, LJ, Juraschek, SP, Cronin, N, McClure, S, Miskimon, J, Mitchell, CM, Kalyani, RR, Roth, DL, Schrack, JA, Szanton, SL, Urbanek, J, Walston, J, Wanigatunga, A, Baksh, SN, Blackford, AL, Chattopadhyay, S, Drye, LT, Dodge, J, Ewing, C, Haider, S, Holland, SC, Jackson, R, Lears, A, Meinert, C, Shade, D, Smith, M, Sternberg, AL, Tonascia, J, Van Natta, ML, Wagoner, A, Comstock, GW, Michos, ED, Bennett, JD, Bowers, P, Coresh, J, Crowley, P, Crunkleton, T, Dick, B, Evans, R, Godwin, M, Hammann, L, Hawks, D, Horning, K, Hull, E, Mills, B, Minotti, M, Raley, L, Reed, A, Reeder, R, Reid, C, Shuda, M, Spikes, A, Stouffer, R, Weicht, K, Abbas, C, Carey, B, Davis, S, DeRoche-Brown, N, Gayles, D, Holland, S, Glenn-Smith, I, Johnson, D, Johnson, M, Keyes, E, Santiago, D, Sapun, C, Sneed, V, Swartz, L, Thomas, L, Christenson, RH, Duh, SH, Rebuck, H, Rosen, C, Cook, T, Duncan, P, Hansen, K, Kenny, A, Shapses, S, Hannah, J, Romashkan, S, Davis, CD, Sempos, CT, Guralnik, JM & Gallagher, JC 2019, 'Recruitment of trial participants through electronic medical record patient portal messaging: A pilot study', Clinical Trials. https://doi.org/10.1177/1740774519873657
Plante, Timothy B. ; Gleason, Kelly T. ; Miller, Hailey N. ; Charleston, Jeanne ; McArthur, Kristen ; Himmelfarb, Cheryl Dennison ; Lazo, Mariana ; Ford, Daniel E. ; Miller, Edgar R. ; Appel, Lawrence J. ; Juraschek, Stephen P. ; Cronin, Nicole ; McClure, Scott ; Miskimon, Jennifer ; Mitchell, Christine M. ; Kalyani, Rita R. ; Roth, David L. ; Schrack, Jennifer A. ; Szanton, Sarah L. ; Urbanek, Jacek ; Walston, Jeremy ; Wanigatunga, Amal ; Baksh, Sheriza N. ; Blackford, Amanda L. ; Chattopadhyay, Shumon ; Drye, Lea T. ; Dodge, John ; Ewing, Cathleen ; Haider, Sana ; Holland, Stephanie C. ; Jackson, Rosetta ; Lears, Andrea ; Meinert, Curtis ; Shade, David ; Smith, Michael ; Sternberg, Alice L. ; Tonascia, James ; Van Natta, Mark L. ; Wagoner, Annette ; Comstock, George W. ; Michos, Erin D. ; Bennett, J. Denise ; Bowers, Pamela ; Coresh, Josef ; Crowley, Patricia ; Crunkleton, Tammy ; Dick, Briana ; Evans, Rebecca ; Godwin, Mary ; Hammann, Lynne ; Hawks, Deborah ; Horning, Karen ; Hull, Erika ; Mills, Brandi ; Minotti, Melissa ; Raley, Leann ; Reed, Amanda ; Reeder, Rhonda ; Reid, Cassie ; Shuda, Melissa ; Spikes, Adria ; Stouffer, Rhonda ; Weicht, Kelly ; Abbas, Caroline ; Carey, Bernellyn ; Davis, Syree ; DeRoche-Brown, Naomi ; Gayles, Debra ; Holland, Sherlina ; Glenn-Smith, Ina ; Johnson, Duane ; Johnson, Mia ; Keyes, Eva ; Santiago, Danielle ; Sapun, Chanchai ; Sneed, Valerie ; Swartz, Lee ; Thomas, Letitia ; Christenson, Robert H. ; Duh, Show Hong ; Rebuck, Heather ; Rosen, Clifford ; Cook, Tom ; Duncan, Pamela ; Hansen, Karen ; Kenny, Anne ; Shapses, Sue ; Hannah, Judy ; Romashkan, Sergei ; Davis, Cindy D. ; Sempos, Christopher T. ; Guralnik, Jack M. ; Gallagher, J. C. / Recruitment of trial participants through electronic medical record patient portal messaging : A pilot study. In: Clinical Trials. 2019.
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title = "Recruitment of trial participants through electronic medical record patient portal messaging: A pilot study",
abstract = "Background/aim: Cost-efficient methods are essential for successful participant recruitment in clinical trials. Patient portal messages are an emerging means of recruiting potentially eligible patients into trials. We assessed the response rate and complaint rate from direct-to-patient, targeted recruitment through patient portals of an electronic medical record for a clinical trial, and compared response rates by differences in message content. Methods: The Study to Understand Fall Reduction and Vitamin D in You (STURDY) trial is a National Institutes of Health–sponsored, community-based study of vitamin D supplementation for fall prevention in older adults conducted at Johns Hopkins. Potential participants were identified using the Epic electronic medical record at the Johns Hopkins Health System based on age (≥70 years), ZIP code (30-mile radius of study site), and prior activation of a patient portal account. We prepared a shorter message and a longer message. Both had basic information about study participation, but the longer message also contained information about the significance of the study and a personal invitation from the STURDY principal investigator. The Hopkins Institutional Review Board did not require prior consent from the patient or their providers. We calculated the response rate and tracked the number of complaints and requests for removal from future messages. We also determined response rate according to message content. Results: Of the 5.5 million individuals receiving care at the Johns Hopkins Health System, a sample of 6896 met our inclusion criteria and were sent one patient portal recruitment message between 6 April 2017 and 3 August 2017. Assessment of enrollment by this method ended on 1 December 2017. There were 116 patients who expressed interest in the study (response rate: 1.7{\%}). Twelve (0.2{\%}) recipients were randomized. There were two complaints (0.03{\%}) and one request to unsubscribe from future recruitment messages (0.01{\%}). Response rate was higher with the longer message than the shorter message (2.1{\%} vs 1.2{\%}; p = 0.005). Conclusion: Patient portal messages inviting seniors to participate in a randomized controlled trial resulted in a response rate similar to commercial email marketing and resulted in very few complaints or opt-out requests. Furthermore, a longer message with more content enhanced response rate. Recruitment through patient portals might be an effective strategy to enroll trial participants.",
keywords = "Clinical trial, electronic medical records, patient portal messages, randomized controlled trial, recruitment methods",
author = "Plante, {Timothy B.} and Gleason, {Kelly T.} and Miller, {Hailey N.} and Jeanne Charleston and Kristen McArthur and Himmelfarb, {Cheryl Dennison} and Mariana Lazo and Ford, {Daniel E.} and Miller, {Edgar R.} and Appel, {Lawrence J.} and Juraschek, {Stephen P.} and Nicole Cronin and Scott McClure and Jennifer Miskimon and Mitchell, {Christine M.} and Kalyani, {Rita R.} and Roth, {David L.} and Schrack, {Jennifer A.} and Szanton, {Sarah L.} and Jacek Urbanek and Jeremy Walston and Amal Wanigatunga and Baksh, {Sheriza N.} and Blackford, {Amanda L.} and Shumon Chattopadhyay and Drye, {Lea T.} and John Dodge and Cathleen Ewing and Sana Haider and Holland, {Stephanie C.} and Rosetta Jackson and Andrea Lears and Curtis Meinert and David Shade and Michael Smith and Sternberg, {Alice L.} and James Tonascia and {Van Natta}, {Mark L.} and Annette Wagoner and Comstock, {George W.} and Michos, {Erin D.} and Bennett, {J. Denise} and Pamela Bowers and Josef Coresh and Patricia Crowley and Tammy Crunkleton and Briana Dick and Rebecca Evans and Mary Godwin and Lynne Hammann and Deborah Hawks and Karen Horning and Erika Hull and Brandi Mills and Melissa Minotti and Leann Raley and Amanda Reed and Rhonda Reeder and Cassie Reid and Melissa Shuda and Adria Spikes and Rhonda Stouffer and Kelly Weicht and Caroline Abbas and Bernellyn Carey and Syree Davis and Naomi DeRoche-Brown and Debra Gayles and Sherlina Holland and Ina Glenn-Smith and Duane Johnson and Mia Johnson and Eva Keyes and Danielle Santiago and Chanchai Sapun and Valerie Sneed and Lee Swartz and Letitia Thomas and Christenson, {Robert H.} and Duh, {Show Hong} and Heather Rebuck and Clifford Rosen and Tom Cook and Pamela Duncan and Karen Hansen and Anne Kenny and Sue Shapses and Judy Hannah and Sergei Romashkan and Davis, {Cindy D.} and Sempos, {Christopher T.} and Guralnik, {Jack M.} and Gallagher, {J. C.}",
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language = "English (US)",
journal = "Clinical Trials",
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TY - JOUR

T1 - Recruitment of trial participants through electronic medical record patient portal messaging

T2 - A pilot study

AU - Plante, Timothy B.

AU - Gleason, Kelly T.

AU - Miller, Hailey N.

AU - Charleston, Jeanne

AU - McArthur, Kristen

AU - Himmelfarb, Cheryl Dennison

AU - Lazo, Mariana

AU - Ford, Daniel E.

AU - Miller, Edgar R.

AU - Appel, Lawrence J.

AU - Juraschek, Stephen P.

AU - Cronin, Nicole

AU - McClure, Scott

AU - Miskimon, Jennifer

AU - Mitchell, Christine M.

AU - Kalyani, Rita R.

AU - Roth, David L.

AU - Schrack, Jennifer A.

AU - Szanton, Sarah L.

AU - Urbanek, Jacek

AU - Walston, Jeremy

AU - Wanigatunga, Amal

AU - Baksh, Sheriza N.

AU - Blackford, Amanda L.

AU - Chattopadhyay, Shumon

AU - Drye, Lea T.

AU - Dodge, John

AU - Ewing, Cathleen

AU - Haider, Sana

AU - Holland, Stephanie C.

AU - Jackson, Rosetta

AU - Lears, Andrea

AU - Meinert, Curtis

AU - Shade, David

AU - Smith, Michael

AU - Sternberg, Alice L.

AU - Tonascia, James

AU - Van Natta, Mark L.

AU - Wagoner, Annette

AU - Comstock, George W.

AU - Michos, Erin D.

AU - Bennett, J. Denise

AU - Bowers, Pamela

AU - Coresh, Josef

AU - Crowley, Patricia

AU - Crunkleton, Tammy

AU - Dick, Briana

AU - Evans, Rebecca

AU - Godwin, Mary

AU - Hammann, Lynne

AU - Hawks, Deborah

AU - Horning, Karen

AU - Hull, Erika

AU - Mills, Brandi

AU - Minotti, Melissa

AU - Raley, Leann

AU - Reed, Amanda

AU - Reeder, Rhonda

AU - Reid, Cassie

AU - Shuda, Melissa

AU - Spikes, Adria

AU - Stouffer, Rhonda

AU - Weicht, Kelly

AU - Abbas, Caroline

AU - Carey, Bernellyn

AU - Davis, Syree

AU - DeRoche-Brown, Naomi

AU - Gayles, Debra

AU - Holland, Sherlina

AU - Glenn-Smith, Ina

AU - Johnson, Duane

AU - Johnson, Mia

AU - Keyes, Eva

AU - Santiago, Danielle

AU - Sapun, Chanchai

AU - Sneed, Valerie

AU - Swartz, Lee

AU - Thomas, Letitia

AU - Christenson, Robert H.

AU - Duh, Show Hong

AU - Rebuck, Heather

AU - Rosen, Clifford

AU - Cook, Tom

AU - Duncan, Pamela

AU - Hansen, Karen

AU - Kenny, Anne

AU - Shapses, Sue

AU - Hannah, Judy

AU - Romashkan, Sergei

AU - Davis, Cindy D.

AU - Sempos, Christopher T.

AU - Guralnik, Jack M.

AU - Gallagher, J. C.

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background/aim: Cost-efficient methods are essential for successful participant recruitment in clinical trials. Patient portal messages are an emerging means of recruiting potentially eligible patients into trials. We assessed the response rate and complaint rate from direct-to-patient, targeted recruitment through patient portals of an electronic medical record for a clinical trial, and compared response rates by differences in message content. Methods: The Study to Understand Fall Reduction and Vitamin D in You (STURDY) trial is a National Institutes of Health–sponsored, community-based study of vitamin D supplementation for fall prevention in older adults conducted at Johns Hopkins. Potential participants were identified using the Epic electronic medical record at the Johns Hopkins Health System based on age (≥70 years), ZIP code (30-mile radius of study site), and prior activation of a patient portal account. We prepared a shorter message and a longer message. Both had basic information about study participation, but the longer message also contained information about the significance of the study and a personal invitation from the STURDY principal investigator. The Hopkins Institutional Review Board did not require prior consent from the patient or their providers. We calculated the response rate and tracked the number of complaints and requests for removal from future messages. We also determined response rate according to message content. Results: Of the 5.5 million individuals receiving care at the Johns Hopkins Health System, a sample of 6896 met our inclusion criteria and were sent one patient portal recruitment message between 6 April 2017 and 3 August 2017. Assessment of enrollment by this method ended on 1 December 2017. There were 116 patients who expressed interest in the study (response rate: 1.7%). Twelve (0.2%) recipients were randomized. There were two complaints (0.03%) and one request to unsubscribe from future recruitment messages (0.01%). Response rate was higher with the longer message than the shorter message (2.1% vs 1.2%; p = 0.005). Conclusion: Patient portal messages inviting seniors to participate in a randomized controlled trial resulted in a response rate similar to commercial email marketing and resulted in very few complaints or opt-out requests. Furthermore, a longer message with more content enhanced response rate. Recruitment through patient portals might be an effective strategy to enroll trial participants.

AB - Background/aim: Cost-efficient methods are essential for successful participant recruitment in clinical trials. Patient portal messages are an emerging means of recruiting potentially eligible patients into trials. We assessed the response rate and complaint rate from direct-to-patient, targeted recruitment through patient portals of an electronic medical record for a clinical trial, and compared response rates by differences in message content. Methods: The Study to Understand Fall Reduction and Vitamin D in You (STURDY) trial is a National Institutes of Health–sponsored, community-based study of vitamin D supplementation for fall prevention in older adults conducted at Johns Hopkins. Potential participants were identified using the Epic electronic medical record at the Johns Hopkins Health System based on age (≥70 years), ZIP code (30-mile radius of study site), and prior activation of a patient portal account. We prepared a shorter message and a longer message. Both had basic information about study participation, but the longer message also contained information about the significance of the study and a personal invitation from the STURDY principal investigator. The Hopkins Institutional Review Board did not require prior consent from the patient or their providers. We calculated the response rate and tracked the number of complaints and requests for removal from future messages. We also determined response rate according to message content. Results: Of the 5.5 million individuals receiving care at the Johns Hopkins Health System, a sample of 6896 met our inclusion criteria and were sent one patient portal recruitment message between 6 April 2017 and 3 August 2017. Assessment of enrollment by this method ended on 1 December 2017. There were 116 patients who expressed interest in the study (response rate: 1.7%). Twelve (0.2%) recipients were randomized. There were two complaints (0.03%) and one request to unsubscribe from future recruitment messages (0.01%). Response rate was higher with the longer message than the shorter message (2.1% vs 1.2%; p = 0.005). Conclusion: Patient portal messages inviting seniors to participate in a randomized controlled trial resulted in a response rate similar to commercial email marketing and resulted in very few complaints or opt-out requests. Furthermore, a longer message with more content enhanced response rate. Recruitment through patient portals might be an effective strategy to enroll trial participants.

KW - Clinical trial

KW - electronic medical records

KW - patient portal messages

KW - randomized controlled trial

KW - recruitment methods

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U2 - 10.1177/1740774519873657

DO - 10.1177/1740774519873657

M3 - Article

C2 - 31581836

AN - SCOPUS:85074028730

JO - Clinical Trials

JF - Clinical Trials

SN - 1740-7745

ER -