A study by researchers at the University of California, San Diego School of Medicine found that technology-based interventions such as text messaging could help adolescents with chronic diseases better manage their healthcare needs as they make the transition into adulthood.
The study is published in the June issue of Pediatrics.
Adolescents with chronic diseases such as cystic fibrosis, gastrointestinal disorders (including Crohn's disease) and Type 1 diabetes, often find the transition of managing their health care needs into adulthood to be challenging. Preparations for this transition are often clinic-based, costly and do not fully or effectively engage with this patient population.
Eighty-one patients, ranging from 12-to-20-years-old, participated in the eight-month study. Those assigned to the intervention group received an Internet and mobile phone system. Patients were asked to use a secure web site weekly to receive theme-based materials and lifestyle tips. Automated text messages were also sent three to five times a week to help patients perform a variety of tasks, such as monitoring symptoms, keeping appointments and interpreting medical bills.
“Parents usually take a leading role when treating adolescents with chronic disease, but we want teenage patients to have a voice and become advocates for their own health,” said principal investigator Jeannie Huang, M.D., with the Department of Pediatrics at UC San Diego School of Medicine and Rady Children's Hospital-San Diego, in a prepared statement. “The goal of the program is ultimately to improve communications between affected teens and their doctors.”
Huang said poor transition experiences are commonly reported among adolescents with chronic diseases and have been linked to an increase in mental health and psychosocial issues.
Participating patients had access to a texting communication system that allowed them to report health concerns via text messages directly sent to the patient's health care team. Huang said this feature resulted in one patient in particular accessing timely emergency care when he might otherwise not have or would likely have waited until his condition had dramatically declined.
“The study found that 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.”
The study also resulted in no adverse events, no confidentiality breaches and showed that patients reported better self-efficacy and confidence in managing their own health care issues.
Huang notes that the use of technology embedded within a medical program provides a low-cost alternative for intervention in at-risk populations distributed across time and geography and is independent of the clinic setting.
