A Digital Care Plan Nudge to Improve Primary Care Outcomes

Area of Science:

• Digital Health Interventions
• Preventive Care
• Primary Care

Background:

• Preventive care services are underutilized in the U.S.
• Digital care plan nudges may encourage patients to address care gaps during primary care visits.

Purpose of the Study:

• To evaluate the effectiveness of a digital care plan nudge in improving the addressing of preventive care gaps during primary care visits.

Main Methods:

• A cluster randomized trial involving 76 primary care practices across four U.S. states.
• Compared usual care with a digital care plan nudge (text messages) sent before patient visits.
• Outcomes included care gaps addressed during the visit (primary) and completed within 90 days (secondary), plus appointment engagement and patient experience.

Main Results:

• The digital care plan nudge did not significantly increase the primary outcome of care gaps addressed during the visit (3.8 percentage points difference, P=0.08).
• The intervention was associated with a significant increase in care gaps completed by 90 days (5.4 percentage points).
• Post hoc analyses indicated improved appointment engagement, including increased completion rates and decreased no-shows and cancellations.

Conclusions:

• The digital care plan nudge intervention did not meet its primary objective of increasing care gaps addressed during primary care visits.
• Secondary outcomes suggest potential benefits for long-term care gap closure and appointment engagement, warranting further investigation.
• Further research is needed to explore the utility of digital nudges in enhancing preventive care delivery.