Evidence

What the research says about coaching patients between visits

PrepQ automates the calls and texts a field team would otherwise field themselves. Structured patient contact around a procedure has been tested in randomized trials. Here is what that research found, and where it stops short of neuromodulation.

Read this part first. None of the studies below evaluated PrepQ, and none of them studied spinal cord stimulation or peripheral nerve stimulation. They tested structured phone and text contact around other procedures, mostly endoscopy and abdominal surgery. We present them as evidence about the approach, not as evidence about this product or this patient population.

Contact before a procedure

Text message instruction

A meta analysis of seven randomized controlled trials covering 5,889 patients found that reinforced education delivered by text message raised the rate of adequate procedure preparation from 75.7 percent to 81.7 percent. Four of those trials also found a significant reduction in patients failing to attend their scheduled procedure.

International Journal of Colorectal Disease, 2022. PubMed 35192000

Phone instruction, and when it works

A separate meta analysis of nine randomized controlled trials covering 3,836 patients found that telephone instruction significantly improved preparation quality. In subgroup analysis, calls placed within one week of the procedure helped, while calls placed earlier than one week did not.

PLOS ONE, 2023. PubMed 37992042

That timing finding is the reason PrepQ contacts patients close to the trial or implant date rather than at scheduling. A patient who was told everything six weeks ago is functionally an uninstructed patient on the night before.

Contact after a procedure

Readmissions and emergency visits

A systematic review and meta analysis of 19 randomized and non randomized studies covering 10,536 patients found that perioperative telemedicine was associated with significant reductions in readmission rates and emergency department visits after abdominal surgery, with no difference in complication rates between the telehealth and conventional care groups.

JAMA Network Open, 2024. doi:10.1001/jamanetworkopen.2024.8555

The recovery window is where a neuromodulation program is most exposed. A trial patient at home on night one with a lead in place, unsure whether what they feel is normal, either reaches someone or does not. The research says that reaching someone changes where that patient ends up.

What this research does not show

The literature is not uniformly positive, and a device company evaluating a vendor deserves to hear that from the vendor.

A randomized clinical trial of 753 patients found no significant difference in attendance or preparation quality between automated text message reminders and usual care. Trials of text based programs aimed at reducing hospital readmissions after discharge have also produced mixed results, with one of the largest showing no significant reduction.

The pattern is that content, timing, and the ability to actually answer the question a patient has appear to matter far more than the presence of automated messaging. A reminder is not the intervention. An answer is.

None of these trials studied spinal cord stimulation, peripheral nerve stimulation, or any neuromodulation population. Applying findings from endoscopy and abdominal surgery to a trial or implant patient is a reasonable inference, not a demonstrated result.

Our own results

PrepQ has not published outcomes data of its own. We are collecting it now with our first programs, measuring routine question volume handled without field team involvement, escalations, and rep hours returned.

When that data exists it will be posted here, whether or not it is flattering. Until then, nothing on this page is a claim about what PrepQ will do for your program, and the figures in our ROI model are modeled estimates rather than measured client results.