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Lumbar Spine DegenerationNOTICENCT04140344

The NOTICE Study: Neurosurgery and OrThopedIcs Communication Evaluation Study Following Lumbar Fusions

A study testing Text Message Group in people with Lumbar Spine Degeneration and Lumbar Spine Instability, run by Duke University at 1 site in United States.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record

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Trial summary

The purpose of this single-blind, randomized, controlled study is to assess the efficacy of "informative text messages" vs "traditional handouts" provided to lumbar spine surgery patients post-operatively. Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
Text Message Group
Could I receive a placebo?
No, everyone receives an active treatment
How many people
224 participants
Where
1 siteUnited States
Study dates
7 Sep 2023to Oct 2027
Phase
Interventional

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Primary lumbar fusion 1-4 levels
  • 18 years or older
  • Degenerative spine diagnosis
  • Answers YES to all the following screening questions:
  • Do you own a mobile phone that is capable of sending and receiving text messages?
  • Do you know how to text and feel comfortable texting?
  • Are you a regular (at least once a day) text-message user?
  • Are you agreeable to regular contact?

Who cannot join

  • Prior lumbar fusions
  • Tumors/infection/trauma
  • Prisoners or institutionalized patients
  • Non-English speaking patients
  • Patients who smokes or with uncontrolled diabetes
  • Participants will be removed from study if discharged to a rehabilitation center or discharged beyond 7 days post-operatively (we are expecting ~15% of patients to be discharged to a rehabilitation center or discharged beyond 7 days post-operatively)

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Claudia E Pamanes, MPH contact

(919) 668-0897

claudia.pamanes@duke.edu

United States1 site, 1 recruiting
  • Duke Neurosurgery and Duke Orthopedics

    Durham, North Carolina, 27710

    Claudia E Pamanes, MPH, 919-668-0897, claudia.pamanes@duke.edu

    Beth Perry, RN, CCRP, (919) 681-2695, beth.perry@duke.edu

    Recruiting

Other trials in United States

About this study

The purpose of this single-blind, randomized, controlled study is to assess the efficacy of "informative text messages" vs "traditional handouts" provided to lumbar spine surgery patients post-operatively.

Read the detailed description

A total of 224 adult patients (18 years or older) undergoing spinal fusion surgery at Duke University Hospital, will be recruited from the Duke Department of Neurosurgery and the Duke Department of Orthopedics. Participants will be consented and will complete standard of care outcomes questionnaires (Visual Analogue Scale, Oswestry Disability Index and Euro-Quol 5D) at the pre-operative clinic visit for baseline comparison. Participants will be randomized, through REDCap, with equal probability to either: A) the control group, with standard post-surgery handouts, or B) the experimental group, which will receive text messages for a period of 2 weeks after surgery (daily for the first week, and every other day for the second week). Text messages were designed to be standardized and automated, with an embedded link to a video regarding at-home, post-surgery-care instructions. Patients will be directed not to respond to the text messages, but to call for any questions or concerns. The primary outcome will be a reduction in 30-days post-surgery readmission rates. The secondary outcomes will be a reduction in 30-days post-surgery ED visits rates, back and leg pain scores, and anxiety levels. These outcomes will be assessed via a phone interview at 30-days (up to max of 37 days) post-discharge for both groups.

Being tested
Text Message Group
Keywords
Lumbar Fusion, Text Message
Medical subject headings
Spondylosis

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Text Message GroupOther

    Also called Guidance via text messaging to lumbar spine surgery patients post-operatively

    The intervention group will receive automated text messages every day for the first week, and every other day for the second week post-operatively. The text messages will follow a series of pre-defined standardized scripts (Appendix 3) with embedded hyperlinks to a video from the providers with further advice. The patient is directed not to respond to the text messages, but to call for any questions or concerns. The text message group will receive a 30-day post-operative phone call to evaluate: number of ED visits, hospital readmissions, and to re-administer the questionnaires completed at baseline visit. Other data to be collected may include the following: number of phone calls to provider, MyChart messages to provider, pain medications, and new problems like pain and infection.

Study groups in NCT04140344
Study groupRoleWhat they receive
ARM 1: Text Message GroupExperimentalThe intervention group will receive automated text messages every day for the first week, and every other day for the second week post-operatively. The text messages will follow a series of pre-defined standardized scripts (Appendix 3) with embedded hyperlinks to a video from the providers with further advice. The patient is directed not to respond to the text messages, but to call for any questions or concerns. The text message group will receive a 30-day post-operative phone call to evaluate: number of ED visits, hospital readmissions, and to re-administer the questionnaires completed at baseline visit. Other data to be collected may include the following: number of phone calls to provider, MyChart messages to provider, pain medications, and new problems like pain and infection.
Receives: Other: Text Message Group
ARM 2: Control groupNo interventionThe control group will be given the standard post-op packet that includes detailed instructions on proper wound care and signs and symptoms of infection. They will not receive text messages. The same outcomes will be assessed in both groups through a 30-day post-operative phone call.

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change in readmission rates within 30 days post-lumbar spine surgery.

    Change in readmission rates within 30 days post-lumbar spine surgery as measured by questionnaire.

    Measured: Baseline, 30 days

Secondary outcomes (3)
  1. Change in Emergency Department (ED) visit rates within 30 days post-lumbar spine surgery.

    Change in Emergency Department (ED) visit rates within 30 days post-lumbar spine surgery as measured by questionnaire.

    Measured: Baseline, 30 days

  2. Change in back and leg pain levels within 30 days post-lumbar spine surgery as measured by "Oswestry Disability Index" (ODI) questionnaire.

    ODI questionnaire is a tool to evaluate a subjective level of functional disability in daily living activities in patients with low back pain. Scores go from 0% (no disability) to 100% (maximum disability possible).

    Measured: Baseline, 30 days

  3. Change in anxiety/depression levels within 30 days post-lumbar spine surgery as measured by "European Quality of Life-5 Dimension" (EQ-5D) questionnaire.

    The EQ-5D is an instrument to quantify health-related quality of life. Scores can be reported as a five digit number in a range from 11111 (full health) to 55555 (worst health).

    Measured: Baseline, 30 days

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted25 Oct 2019
  2. Study start7 Sep 2023
  3. Primary completionOct 2026 (estimated)
  4. Study completionOct 2027 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Other
Allocation
Randomised
Intervention model
Parallel groups
Model description
Following baseline assessments, subjects will be randomized with equal probability to one of two arms: 1). The experimental arm, which will receive automated standardized text messages at predetermined intervals, occurring daily the first week post-operatively and gradually tapering over the second week; 2). The control arm - where subjects will not receive any scheduled contact (outside of standard of care phone interactions). All subjects will receive a phone call 30 days (up to 37 days) post-discharge in order to complete the study questionnaires.
Masking
Single blind
Who is masked
Participant
Enrolment
224 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04140344
Sponsor's protocol ID
Pro00103904
Acronym
NOTICE
Status last verified
May 2026
First submitted
24 Oct 2019
Last updated
8 May 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

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