Cincinnati doctors are experimenting with texting to tackle a big problem: Tweens and teens too often do a lousy job of controlling chronic illnesses such as asthma, diabetes or kidney disease.
It's a problem long recognized in adults, particularly for illnesses that can simmer without obvious symptoms until it's too late. But only now are doctors realizing how tricky a time adolescence is for skipping meds, too.
There are few good statistics on how many chronically ill kids don't adhere to therapy. But what little data exists is alarming enough that the National Institute of Health's National Institute of Diabetes and Digestive and Kidney Diseases will bring specialists together in September to debate next steps:
- Some studies suggest only half of adolescents, on average, properly follow treatment steps, says Dr. Dennis Drotar of Cincinnati Children's Hospital. The more medications required or the more troublesome the side effects -- even, for appearance-conscious teens, such things as weight gain from steroid medications -- the worse kids adhere.
- Asthma's record is particularly bad, with research suggesting as few as 30 percent of teenagers correctly take medication to prevent asthma attacks.
Dr. Drotar once used a monitor to detect whether cystic fibrosis patients performed a chest-thumping therapy to clear their lungs. One teen's monitor showed weird readings: He'd strapped it onto his dog.
Enter text messages.
Dr. Maria Britto, an asthma specialist at Cincinnati Children's, noticed that even when she's talking to adolescent patients on the clinic exam table, they'll keep texting on their cell phones.
It sparked the idea for a study to see whether a daily medication reminder via text message would improve children's asthma control -- preventing full-blown attacks, improving school attendance and decreasing doctor and emergency-room visits. After all, Dr. Britto says, children as young as 12 carry the phones into her clinic.
Pilot testing recently began, with a full study set for later this year. Participants say what time they want the reminder, and a clinic volunteer types out the messages.