Texting for better health?

Intro
It’s easy to think that chronic health conditions are just for the elderly.

But in the US alone it’s estimated that 15-20% of all adolescents are living with a chronic health condition.

One way to help this population is with better medication adherence.

In fact, non-adherence rates are estimated at 50-75% for paediatric patients, and even higher for adolescents. This results in decreased health related quality of life and increased morbidity and mortality.

Like it or not, adolescents are always on their phones…(almost as bad as OTs!). The good news is texts and phone apps have been shown to be particularly promising interventions for youth. 

So can text messages and mobile phone apps improve medication adherence for adolescents living with chronic health conditions?

Today's Paper
Badawy, S. M., Barrera, L., Sinno, M. G., Kaviany, S., O’Dwyer, L. C., & Kuhns, L. M. (2017). Text messaging and mobile phone apps as interventions to improve adherence in adolescents with chronic health conditions: a systematic review. JMIR mHealth and uHealth, 5(5).

Details

  • Systematic literature review registered in the PROSPERA database, using the PRISMA guidelines and the GRADE approach for quality of evidence

  • Included all pertinent literature on the use of text messaging or mobile phone apps as interventions to improve medication adherence among adolescents (age 12 - 14) with chronic health conditions (2005-2015)

  • 15 articles included (RCT’s, quasi experimental and pilot studies)

  • Measures of adherence included biomarkers, client self report, or assessment by health care professionals


Results

  • 7/15 studies reported statistically significant improvements in medication adherence and health outcomes associated with text messaging or mobile phone apps, with moderate to large standardized mean differences of subjective and objective markers of adherence

  • Most studies included 1, 2 or 3 daily text reminders

  • Most studies reported high satisfaction and low technical / feasibility problems among patients.


Summary
Supporting adolescents with chronic health condition in better self management is critical for their health and quality of life, and the use of text messages and mobile phone apps to promote medication adherence seems like a low risk, feasible option.

Future research here will help clarify the ‘dosage’ required for long term durability of this strategy and any other possible barriers to use.

Regardless, current research suggests that adolescents have a relatively high tolerance for text messaging as an intervention...so it's likely to be well received, and may help.

Takeaway
Text messaging and mobile phone apps show promise as tools to support your adolescent patients with chronic illness.

Maybe using your (work) cell phone isn’t so bad ;-)