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Text Messaging for Disease Monitoring in Childhood Nephrotic Syndrome

Chia-Shi Wang1, Jonathan P Troost2, Larry A Greenbaum1

  • 1Department of Pediatrics, Emory University and Children's Healthcare of Atlanta, Atlanta, Georgia, USA.

Kidney International Reports
|August 24, 2019
PubMed

Insights

Text messaging systems (SMS) effectively monitor childhood nephrotic syndrome, improving relapse detection and remission time. This novel approach shows high patient acceptance and reliable disease activity capture between visits.

Area of Science:

  • Pediatric Nephrology
  • Digital Health
  • Clinical Trial Methodology

Background:

  • Limited data exists on effective disease monitoring for prompt intervention in childhood nephrotic syndrome.
  • A multicenter, prospective study investigated a novel text messaging system (SMS) for disease monitoring.

Purpose of the Study:

  • To assess the feasibility and effectiveness of an SMS system for monitoring nephrotic syndrome in children.
  • To evaluate SMS adoption, retention, engagement, and data concordance with clinical assessments.

Main Methods:

  • 127 pediatric patients (<19 years) with incident nephrotic syndrome were enrolled.
  • Caregivers or adolescent patients received SMS prompts for urine protein, symptoms, and adherence.
  • SMS data was compared with laboratory/clinician assessments and conventional visit data.

Main Results:

  • 94% of patients agreed to SMS monitoring, with a 94% retention rate and high engagement (87% median response rate).
  • Excellent concordance was observed between SMS-reported and in-person assessed urine protein (kappa=0.88) and edema (kappa=0.92).
  • SMS detected more relapses (108 vs. 41) and showed a shorter median time to remission (22 vs. 50 days) compared to scheduled visits.

Conclusions:

  • SMS monitoring is well-accepted by caregivers and adolescent patients.
  • The system reliably captures nephrotic syndrome disease activity between clinic visits.
  • Further research is needed to explore the impact of SMS on disease outcomes.
Abstract

Keywords:
caregiverschildrenhealth statusmobile healthnephrotic syndrometext messaging

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