SMS Resources Beneficial to Patients With Rheumatic Diseases During the COVID-19 Pandemic

woman using cellphone for telemedicine, telehealth
SMS-embedded video links may be a potential tool for rheumatology departments to contact patients during and after the COVID-19 pandemic.

Video links embedded in SMS may be a potential tool for rheumatologists to provide guidance to patients during and after the coronavirus disease 2019 (COVID-19) pandemic, according to a report published in The Lancet Rheumatology.

Researchers in the United Kingdom aimed to improve the distribution of urgent communication of targeted healthcare information to at-risk patients with autoimmune rheumatic diseases and collect centralized national identification of patients in at-risk groups.

Rheumatologists were presented with a 40-component physician-scored tool for the risk stratification of patients, according to the British Society for Rheumatology, and to advise patients with illness on therapy, including corticosteroid use. For this intervention, the researchers used electronic learning platforms that are already in use in the education of health professionals, which allow publication, distribution, and user metrics of multimedia resources sent by a shareable web link to educate patients in a large secondary care rheumatology service in the United Kingdom.

The message communicated patient-led risk scores via an SMS link to a web-based instructional video adapted from physician-led guidance and included a 4-step risk score, an animated worked example, and information from regulatory bodies and specialist societies. Patients were contacted using an existing database of mobile phone numbers that were previously used to send messages via SMS to their rheumatology cohort from March 22, 2019 to March 22, 2020.

At first, a subset of patients (n=200; 69.0% women; 29.0% aged 50-59 years) were asked about their experiences in a national request to contact patients using rheumatology services. On day 4, the researchers of the study sent out 12,241 SMS video-linked messages; on day 6, there were 5226 (42.6%) video views with 1167 completed patient evaluations (22.3% of viewer responses). Of patients who completed evaluations, 1105 (95.6%) of 1156 who completed risk stratification responses reported successful self-risk assessment, including patients at low risk (n=237 [20.5%]), medium risk (n=544 [47.1%]), and high risk (n=324 [28.0%]).

The SMS video link technology was shared with a regional hospital network in the United Kingdom and the video was later adopted for use in 2 rheumatology units, of which 1 distributed this information to patients using their SMS system.

“The strengths of this innovative method for communicating with patients are its speed, scale and positive patient experiences,” the authors of this report concluded. “This work demonstrates that SMS-linked technology is well placed to assist physicians, and might be of interest to national advisory bodies, hospitals, and primary care groups when planning mass healthcare communication.”

Disclosure: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.


Bateman J, Mulherin D, Hirsch G, Venkatachalam S, Sheeran T. Rapid distribution of information by SMS-embedded video link to patients during a pandemic [published online May 6, 2020.] Lancet Rheumatol. doi:10.1016/S2665-9913(20)30126-0