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

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.