Real-time fatigue reduction in emergency care clinicians: The SleepTrackTXT randomized trial

• Published in: American journal of industrial medicine Vol. 58; no. 10; pp. 1098 - 1113
• Main Authors: Patterson, P. Daniel, Buysse, Daniel J., Weaver, Matthew D., Doman, Jack M., Moore, Charity G., Suffoletto, Brian P., McManigle, Kyle L., Callaway, Clifton W., Yealy, Donald M.
• Format: Journal Article
• Language: English
• Published: United States Blackwell Publishing Ltd 01-10-2015; Wiley Subscription Services, Inc
• Subjects: Adolescent; Adult; Aged; Emergency Medical Services; fatigue; Fatigue - etiology; Fatigue - prevention & control; Female; Follow-Up Studies; Humans; injury; Male; Middle Aged; mobile; Occupational Diseases - etiology; Occupational Diseases - prevention & control; shiftwork; Single-Blind Method; Sleep; sleepiness; Text Messaging; Treatment Outcome; Work Schedule Tolerance; Young Adult; mobile; fatigue; injury; sleepiness; shiftwork
• ISSN: 0271-3586; 1097-0274
• DOI: 10.1002/ajim.22503

Background
We assessed performance characteristics and impact of a mobile phone text‐message intervention for reducing intra‐shift fatigue among emergency clinician shift workers.
Methods
We used a randomized controlled trial of 100 participants. All participants received text‐message assessments at the start, every 4 hr during, and at end of scheduled shifts over a 90‐day period. Text‐message queries measured self‐rated sleepiness, fatigue, and difficulty with concentration. Additional text‐messages were sent to intervention participants to promote alertness. A performance measure of interest was compliance with answering text‐messages.
Results
Ninety‐nine participants documented 2,621 shifts and responded to 36,073 of 40,947 text‐messages (88% compliance rate). Intervention participants reported lower mean fatigue and sleepiness at 4 hr, 8 hr, and at the end of 12 hr shifts compared to controls (P < 0.05). Intervention participants reported better sleep quality at 90‐days compared to baseline (P = 0.01).
Conclusions
We showed feasibility and short‐term efficacy of a text‐message based assessment and intervention tool. Am. J. Ind. Med. 58:1098–1113, 2015. © 2015 Wiley Periodicals, Inc.