TY - JOUR
AU - J. A. Pagliaro
AU - L. K. Wash
AU - K. Ly
AU - J. Mathew
AU - A. Leibowitz
AU - R. Cabrera
AU - J. B. Wormwood
AU - V. G. Vimalananda
A1 - 
AB - BACKGROUND: Clinical trials of remote patient monitoring (RPM) technology are well-suited to remote studies, for which patients complete key procedures online. However, remote digital health studies often suffer from low enrollment and retention, threatening the successful achievement of study outcomes and wasting resources and time. Recruiting patients from a large integrated health system offers a greater potential pool of participants for enrollment, which can increase the likelihood of successful study completion. OBJECTIVE: This study describes enrollment and retention outcomes for a remote digital health study of an RPM device conducted in collaboration with researchers from the Veterans Health Administration (VA). The VA is the largest integrated health system in the United States, with 9 million enrollees who are, as a group, older and with more medical and mental health comorbidities than the civilian population. METHODS: We aimed to enroll 200 VA patients for a clinical study of a cellular-enabled, handheld, multisensor device that captures multiple health parameters and transmits data to a cloud-based dashboard for viewing by clinicians. Eligible patients were hospitalized with COVID-19 within 3-6 months before enrollment and had one of 6 pre-existing medical comorbidities. Potentially eligible patients were identified using the VA Corporate Data Warehouse. Every 3 weeks, up to 1000 potentially eligible patients were mailed a recruitment letter. All study tasks, including obtaining informed consent, device training and troubleshooting, and handling study-related questions, were completed online and by telephone. Device and survey data were combined with VA clinical and utilization data to develop a predictive algorithm for clinical decompensation. The geographic distribution of enrolled patients was mapped by county. Demographic and health characteristics of nonenrolled versus enrolled, and of completers versus noncompleters were compared using t tests and chi-square tests as appropriate. Reasons for noncompletion were summed. Multivariate logistic regression was used to evaluate variables associated with enrolling versus nonenrolling, and completing versus noncompleting. RESULTS: Of the 7714 who were mailed a study invitation, 560 were screened. Of the screened patients, 203 were enrolled (2.9% enrollment yield) and 166 completed the study (82% retention rate). Enrolled patients were broadly distributed across the United States. Among those enrolled, completers and noncompleters were similar except for a slightly higher proportion of patients with hypertension among completers. The most common reason for noncompletion of the study was that participants were unable to be contacted for study tasks. CONCLUSIONS: Remote digital health studies are increasingly common, but inadequate enrollment often results in failed studies. Recruiting patients through the VA enables access to a very large population of potentially eligible patients and can help ensure that clinical trials reach targets for enrollment and completion. TRIAL REGISTRATION: ClinicalTrials.gov NCT05713266; https://clinicaltrials.gov/study/NCT05713266.
AD - Center for Health Optimization and Implementation Research, VA Bedford Medical Center, Bedford, MA, United States.; Neurological Clinical Research Institute, Massachusetts General Hospital, Boston, MA, United States.; Clinical Informatics, Providence VA Medical Center, Providence, RI, United States.; Aidar Health, Inc, Columbia, MD, United States.; Department of Psychology, University of New Hampshire, Durham, NC, United States.; Chobanian & Avedisian School of Medicine, Boston University, Boston, MA, United States.
AN - 40334212
BT - JMIR Form Res
C5 - Healthcare Disparities; HIT & Telehealth
DA - Aug 15
DO - 10.2196/68676
DP - NLM
ET - 20250815
JF - JMIR Form Res
LA - eng
N2 - BACKGROUND: Clinical trials of remote patient monitoring (RPM) technology are well-suited to remote studies, for which patients complete key procedures online. However, remote digital health studies often suffer from low enrollment and retention, threatening the successful achievement of study outcomes and wasting resources and time. Recruiting patients from a large integrated health system offers a greater potential pool of participants for enrollment, which can increase the likelihood of successful study completion. OBJECTIVE: This study describes enrollment and retention outcomes for a remote digital health study of an RPM device conducted in collaboration with researchers from the Veterans Health Administration (VA). The VA is the largest integrated health system in the United States, with 9 million enrollees who are, as a group, older and with more medical and mental health comorbidities than the civilian population. METHODS: We aimed to enroll 200 VA patients for a clinical study of a cellular-enabled, handheld, multisensor device that captures multiple health parameters and transmits data to a cloud-based dashboard for viewing by clinicians. Eligible patients were hospitalized with COVID-19 within 3-6 months before enrollment and had one of 6 pre-existing medical comorbidities. Potentially eligible patients were identified using the VA Corporate Data Warehouse. Every 3 weeks, up to 1000 potentially eligible patients were mailed a recruitment letter. All study tasks, including obtaining informed consent, device training and troubleshooting, and handling study-related questions, were completed online and by telephone. Device and survey data were combined with VA clinical and utilization data to develop a predictive algorithm for clinical decompensation. The geographic distribution of enrolled patients was mapped by county. Demographic and health characteristics of nonenrolled versus enrolled, and of completers versus noncompleters were compared using t tests and chi-square tests as appropriate. Reasons for noncompletion were summed. Multivariate logistic regression was used to evaluate variables associated with enrolling versus nonenrolling, and completing versus noncompleting. RESULTS: Of the 7714 who were mailed a study invitation, 560 were screened. Of the screened patients, 203 were enrolled (2.9% enrollment yield) and 166 completed the study (82% retention rate). Enrolled patients were broadly distributed across the United States. Among those enrolled, completers and noncompleters were similar except for a slightly higher proportion of patients with hypertension among completers. The most common reason for noncompletion of the study was that participants were unable to be contacted for study tasks. CONCLUSIONS: Remote digital health studies are increasingly common, but inadequate enrollment often results in failed studies. Recruiting patients through the VA enables access to a very large population of potentially eligible patients and can help ensure that clinical trials reach targets for enrollment and completion. TRIAL REGISTRATION: ClinicalTrials.gov NCT05713266; https://clinicaltrials.gov/study/NCT05713266.
PY - 2025
SN - 2561-326x
SP - e68676
ST - Enrollment and Retention Outcomes from the Veterans Health Administration for a Remote Digital Health Study: Multisite Observational Study
T1 - Enrollment and Retention Outcomes from the Veterans Health Administration for a Remote Digital Health Study: Multisite Observational Study
T2 - JMIR Form Res
TI - Enrollment and Retention Outcomes from the Veterans Health Administration for a Remote Digital Health Study: Multisite Observational Study
U1 - Healthcare Disparities; HIT & Telehealth
U3 - 10.2196/68676
VL - 9
VO - 2561-326x
Y1 - 2025
ER -