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A text-based patient-reported outcomes system emerges as a practical, scalable tool in FQHCs, strengthening real-time knee osteoarthritis symptom tracking and spotlighting the need for better patient education.
A new U.S. study highlights how digital health tools—specifically short message service (SMS)-based patient-reported outcome (PRO) surveys—could transform knee osteoarthritis (OA) care for underserved populations.
Knee OA remains a widespread, chronic condition in the United States, placing a substantial burden on quality of life, functional mobility, and health-care spending. Persistent disparities across racial, ethnic, and socioeconomic groups underscore the essential role of federally qualified health centers (FQHCs) in supporting underserved communities. As digital health tools become increasingly integrated into primary care, mobile-based PROs offer a promising pathway for monitoring chronic symptoms in low-resource settings.
Against this backdrop, the study aimed to evaluate whether a text message–driven PRO system was feasible for collecting knee OA symptom data, engaging primary care patients, and identifying barriers to digital participation in FQHC environments. The research team assessed 223 FQHC primary care patients diagnosed with knee OA. Participants were invited via text message to complete a standardized PRO survey assessing knee pain, function, and symptom burden. Individuals who did not initially respond received follow-up reminders through both text messaging and phone calls to encourage participation.
They also examined overall and language-specific response rates, identified reasons for noncompletion, and analyzed patient feedback regarding usability, trust, and expectations for ongoing digital symptom monitoring. Qualitative insights from both responders and nonresponders were incorporated to capture broader attitudes toward text-based PRO engagement. The pilot study yielded a 24.7% overall response rate, with notable differences between language groups:
Disconnected or inactive phone numbers emerged as the most frequent barrier to survey completion. Feedback from participants revealed high enthusiasm for continued symptom monitoring, with 92% expressing support for routine tracking of knee OA symptoms. Responders reported that the digital survey was easy to navigate, while nonresponders described challenges related to technical reliability, comfort with digital tools, and trust in the communication process.
Thus, text message–based PRO collection proved to be a scalable, acceptable, and effective tool for monitoring chronic knee OA, especially in FQHC environments. The approach showed strong potential for scalable use in chronic care settings, provided patients received clear education about the purpose and value of PRO reporting. The findings also highlighted that enhanced communication, reliable contact pathways, and culturally tailored engagement strategies were essential for maximizing participation and improving symptom management in resource-limited primary care environments.
Arthroplasty Today
Primary Care Patient Engagement With Patient-Reported Outcomes to Assess Osteoarthritis Symptoms
Martha Burla et al.
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