HealthLawProf Blog

Editor: Katharine Van Tassel
Concordia University School of Law

Monday, April 28, 2008

Reminder Text Messages to Teens for Meds

The Cincinnati Enquirer reports today on a new program by Cincinnati Children's Medical Center to help remind teenagers to take their medications - text messages.   Peggy O'Farrell writes,

Tylor Thomas, 16, has never counted how many text messages he gets in a day, but it's a lot.  Tucked in among all those shout-outs from friends, one potentially lifesaving message arrives every morning around 9 for the Winton Hills teen.  "They just text me and tell me, 'Hi. Don't forget to take your asthma meds,' " Tylor said.  He's one of a handful of teens participating in a Cincinnati Children's Hospital Medical Center pilot project to determine how well text-message reminders work to help teens manage their asthma.

If text messages are an effective solution for asthma management, there's no reason they won't work for patients with diabetes or other chronic illnesses, said Maria Britto, an adolescent medicine specialist at Children's.  Britto, director of the center for innovation in chronic disease care and assistant vice president for chronic disease programs at Children's, coordinates the pilot project.  Whether they're 16 or 60, patients with chronic diseases aren't good about sticking to their treatment regimen, experts say. Only about half take their medicine when they're supposed to, the way they're supposed to, Britto said.

"The longer you have to take the medicine, the lower your adherence rate is. If you have strep throat, the doctor gives you an antibiotic and tells you to take it for 10 days, and it's not a big deal. But if it's a medication you have to take every day for a long time and it has side effects you don't like, you're not going to take it every day," she said.  Teens are a tricky patient population, as any parent can attest. Sometimes not taking their medicine is an attempt at independence.  More often, they just forget.

"One of the barriers to adherence is the fact that many asthma medications really work over the long term, in that they prevent symptoms from happening," said Dennis Drotar, a psychologist at Cincinnati Children's. "But teenagers live in the short-term, so today and tomorrow are more important than not having an asthma attack six months from now."  Tylor was diagnosed with asthma when he was about 3. His symptoms are pretty well controlled, but he uses an inhaler once a day to prevent asthma attacks.

Between school, playing on the basketball team and singing in the Miami Baptist Church choir, it's easy to forget about his inhaler.  "Sometimes, like if I'm playing, I'll skip it. If I need it later, then I'll take it," Tylor said.  Text messaging teens to take their medicine seemed like a natural fit, Britto said, especially once she and her colleagues noticed their patients were constantly texting, even during office visits.  It's a preferred form of communication, and it's so common that their friends won't notice they're getting one more message. . . .

Most texts are medication reminders. But as the new system takes hold, Britto said, the possibilities are endless, including sending appointment reminders and test results.

"We could send out messages about other issues, like avoiding triggers, or not going outside when there's a smog alert or the pollen count's too high. Or if someone is trying to quit smoking or change another behavior, we could send out messages," she said.

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