A collaborative study in the journal Pediatrics conducted by researchers at University of Texas School of Public Health, University of California-San Diego, and Rady Children’s Hospital shows that communicating via text messages may help adolescents with chronic diseases transition into independent adult care.
The study evaluated 81 adolescents with chronic disease (ACD) over a period of six months after the subjects completed two months of intensive web- and text-based disease management and skill-based intervention. Control-group ACD received only materials on general health topics through the mail. ACD who received the technological-based training demonstrated better disease management tasks, health-related self-efficacy, and patient-initiated communications.
These results are beneficial because ACD–which include patients with cystic fibrosis, gastrointestinal disorders, and type 1 diabetes–sometimes find it difficult to manage their health conditions while transitioning into adulthood. “Parents usually take a leading role when treating ACD, but we want teenage patients to have a voice and become advocates for their own health,” said Jeannie Huang, MD, from the UCSD School of Medicine and Rady Children’s Hospital, in a news release. “The goal of the program is to ultimately improve communications between affected teens and their doctors.”
Instructing teenagers to use technology in a way to manage their diseases is less costly than the orthodox clinic-based education programs that often do not fully or effectively engage patients. A secure web site and automated text messages enabled the ACD to receive theme-based materials, lifestyle tips, help with interpreting medical bills, and reminders for appointments. “By communicating using technology in a secure way, we are meeting these patients where they are and becoming more intimately involved in their health care journey and preparation into adulthood,” said Dr. Huang.
One story of success immediately resulted from the study. A patient who might have hesitated to receive treatment for an emergency condition used the texting communication system to report his concern directly to his health care team.
Other successes not related to this study that use technology to help patients with disease management are being implemented. Engaging cystic fibrosis patients with multimedia kits has been shown to help patients adhere to their physiotherapy.
“The study found patients were communicating more with their physicians via text message and phone, and health care providers were utilizing the technology to start a productive dialogue with young patients and triage in an innovative way,” said Huang. “In prior patient interviews, we found that advice given via a technology-based intervention appeared to be better tolerated. Patients felt they weren’t being judged when reporting issues by technology rather than in person.”
At the same time, the researchers found, teenagers were not abusing the program, and their privacy was maintained. No adverse events were reported, only better self-efficacy and confidence in managing the teenagers’ health care issues.
“We hope to do further studies to understand how to keep this momentum going and continue to empower adolescents as they enter the next phase of their life while managing their disease,” concluded Dr. Huang.