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Published on: September 20, 2018
Text Messaging Effect on Adherence in Children With Inflammatory Bowel Disease
Tamir Miloh1, Mitchell Shub, Ramon Montes
1*Baylor College of Medicine, Texas Children's Hospital, Houston, TX †Phoenix Children's Hospital, University of Arizona, Phoenix, Arizona.
Insights
Text messaging (TM) reminders improved medication adherence in children with inflammatory bowel disease (IBD). This study suggests TM interventions can enhance treatment compliance for pediatric IBD patients.
Area of Science:
- Pediatric Gastroenterology
- Digital Health Interventions
- Chronic Disease Management
Background:
- Adherence to medication is crucial for successful inflammatory bowel disease (IBD) treatment.
- Nonadherence in pediatric IBD patients leads to increased relapses, morbidity, and healthcare costs.
Purpose of the Study:
- To evaluate the effectiveness of a text messaging (TM) intervention in improving medication adherence among pediatric patients with IBD.
- To assess the impact of TM reminders on treatment compliance and disease management in children with IBD.
Main Methods:
- A randomized controlled trial involving 51 pediatric IBD patients receiving oral medication.
- Intervention group received 2-way TM reminders, alerts for missed doses, and weekly compliance reports.
- Adherence was measured using the Morisky questionnaire at baseline, 6, and 12 months.
Main Results:
- The TM intervention group showed a significant improvement in Morisky scores at 6 months (P=.0131).
- While the TM group demonstrated improved adherence, the control group did not show significant changes.
- Baseline characteristics were similar between the TM and control groups, ensuring comparability.
Conclusions:
- Text messaging (TM) interventions show promise in enhancing medication adherence for pediatric patients with IBD.
- Further large-scale, multicenter studies are needed to validate these findings and confirm the long-term efficacy of TM for IBD management.
Background:
Successful treatment of patients with inflammatory bowel disease (IBD) requires regular intake of medication. Nonadherence to treatment is associated with increased frequency of relapses, morbidity, and cost.
Methods:
Pediatric patients with IBD taking oral medication and with access to text messaging (TM) services were included. Children were randomized by age, sex, medication administration responsibility (self vs parent), and disease activity (Pediatric Crohn Disease Activity Index or Pediatric Ulcerative Colitis Activity Index) into TM intervention and standard of care. Prospectively, the interventional group received 2-way TM reminders about medication administration. Failure to confirm intake by the patient resulted in a TM alert to the caregiver and weekly compliance reports were sent to patients, caregivers, and healthcare providers. Patients' medical records were reviewed and an adherence Morisky questionnaire completed at recruitment, 6 and 12 months.
Results:
A total of 51 children were randomized (21 TM and 30 control). The age, sex, diagnosis (ulcerative colitis/Crohn), activity index, ethnicity, insurance, and Morisky score at baseline were similar in both groups. Morisky score improved by 1 and 0.8 points, respectively in the TM group at 6 and 12 months, whereas it did not change in the control group (P = 0.0131 and P = 0.1687, prospectively).
Conclusions:
TM may be effective in promoting adherence in children with IBD. Larger and longer multicenter studies are required to confirm this finding.
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