title: Usefulness of cellular text messaging for improving adherence among adolescents and young adults with systemic lupus erythematosus.
abstract: OBJECTIVE
  In a cohort of 70 patients with childhood-onset systemic lupus erythematosus (cSLE): to determine the baseline adherence to medications and visits; to investigate the effects of cellular text messaging reminders (CTMR) on adherence to clinic visits; and to study the influence of CTMR on adherence to use of hydroxychloroquine (HCQ).
  
  
  METHODS
  CTMR were sent to 70 patients prior to clinic visits for 14 months. A subgroup of patients were evaluated for medication adherence to HCQ: 19 patients receiving CTMR prior to each scheduled HCQ dose were compared to 22 patients randomized to standard of care education about HCQ. Visit adherence was measured using administrative databases. Pharmacy refill information, self-report of adherence, and HCQ blood levels were utilized to monitor medication adherence to HCQ. Sufficient adherence to visits or HCQ was defined as estimates > 80%. Disease activity was primarily monitored with the Systemic Lupus Erythematosus Disease Activity Index.
  
  
  RESULTS
  At baseline, 32% of patients were sufficiently adherent to HCQ, and 81% to clinic visits. Visit adherence improved significantly by > 80% among those who were nonadherent to clinic visits at the baseline CTMR (p = 0.01). CTMR did not influence adherence to HCQ over time.
  
  
  CONCLUSIONS
  Patients with cSLE were only modestly adherent to HCQ and clinic visits. CTMR may be effective for improving visit adherence among adolescents and young adults with cSLE, but it does not improve adherence to HCQ.
authors.affiliation: Cincinnati Children's Hospital Medical Center, William Rowe Division of Rheumatology, MLC 4010, 3333 Burnet Avenue, Cincinnati, OH 45229-3039, USA. tracy.ting@cchmc.org
authors.forename: Tracy V
authors.initials: TV
authors.lastname: Ting
authors.forename: Deepa
authors.initials: D
authors.lastname: Kudalkar
authors.forename: Shannen
authors.initials: S
authors.lastname: Nelson
authors.forename: Sandra
authors.initials: S
authors.lastname: Cortina
authors.forename: Joshua
authors.initials: J
authors.lastname: Pendl
authors.forename: Shaaista
authors.initials: S
authors.lastname: Budhani
authors.forename: Jennifer
authors.initials: J
authors.lastname: Neville
authors.forename: Janalee
authors.initials: J
authors.lastname: Taylor
authors.forename: Jennifer
authors.initials: J
authors.lastname: Huggins
authors.forename: Dennis
authors.initials: D
authors.lastname: Drotar
authors.forename: Hermine I
authors.initials: HI
authors.lastname: Brunner
mesh_terms: D000293:Adolescent; D000554:Ambulatory Care Facilities; D018501:Antirheumatic Agents / Q000097:blood / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006886:Hydroxychloroquine / Q000097:blood / Q000627:therapeutic use*; D008180:Lupus Erythematosus, Systemic / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D055118:Medication Adherence; D010349:Patient Compliance; D011795:Surveys and Questionnaires; D060145:Text Messaging; D055815:Young Adult
chemical_list: D018501:Antirheumatic Agents; D006886:Hydroxychloroquine