Text Message Reminders for Good for Teen Transplant Patients
Tamir Miloh, MD and colleagues (Mount Sinai Hospital in New York) presented their research at the Digestive Disease Week in Chicago this week. Their study looked at improving compliance rates in pediatric liver transplant recipients by using text messaging.
Once a patient receives a liver transplant, the patient needs to take medication regularly to prevent their body from rejected the transplanted organ. Children and adolescents often have trouble remembering to take their medication regularly. It doesn’t help that liver patients may also suffer memory problems. It is estimated that as many as 40 percent of adolescents with a liver transplant. It may only take two missed dosed of medication for the body to reject the transplanted liver. Young people are generally technologically savvy which prompted the researchers to determine whether sending text messages would result in improved adherence.
The study looked at 41 young people (average age 15 years) who were liver transplant recipients. The MediM AS system from CareSpeak Communications, which funded the study, was used to decide which time of day patients/or caregivers preferred to receive a medication reminder via text message. Once the message was received, the patients had 15 minutes to send a reply text confirming the medication had been taken. Another message would be automatically sent to the parents if they did not. Researchers tracked by computer how many times patients replied, did not reply or had to have parental intervention.
The researchers looked at two factors to determine the effectiveness of the text reminders -- the level of medication in the patient’s blood and whether their bodies rejected the liver transplant. Patients who took medication erratically had a higher deviation of medication in their blood, compared to patients who took their medication regularly.
In the year prior to the study, 12 of 41 patients experienced rejection that required hospitalization and treatment because the patient’s body rejected the transplant due to improper medication dosage. But one year into this study, just two patients suffered rejection of the liver.
Thirteen patients dropped out, mainly because of cost, as families had to pay for the phones and text messaging. Even so, these patients still showed improved compliance with taking their meds. The researchers feel that behavioral changes were learned and reinforced during the time the teenager received the text reminders which they continued after dropping out of the study.
The researchers are applying for a grant to conduct a larger trial, in which cell phones and service charges will be provided.