title: Text Messaging Improves Participation in Laboratory Testing in Adolescent Liver Transplant Patients.
abstract: BACKGROUND
  In solid organ transplant patients, non-participation in all aspects of the medical regimen is a prevalent problem associated with adverse consequences particularly in the adolescent and young adult (AYA) age group. This study is the first to evaluate the feasibility, utility and impact of a text messaging (TM) intervention to improve participation in laboratory testing in adolescent liver transplant patients.
  
  
  METHODS
  AYA patients, aged 12 to 21 years, were recruited for a prospective pilot trial evaluating a TM intervention delivered over a 1-year period. The intervention involved automated TM reminders with feedback administered according to a prescribed laboratory testing frequency. Participation rate in laboratory testing after the intervention was compared to the year prior. Patient responses and feedback by text and survey were used to assess feasibility, acceptability and use of the intervention.
  
  
  RESULTS
  Forty-two patients were recruited and 33 patients remained enrolled for the study duration. Recipients of the TM intervention demonstrated a significant improvement in participation rate in laboratory testing from 58% to 78% (P<.001). This rate was also significantly higher than in non-intervention controls (P=.003). There was a high acceptability, response rate and a significant correlation with reported versus actual completion of laboratory tests by TM.
  
  
  CONCLUSIONS
  TM reminders significantly improved participation in laboratory testing in AYA liver transplant patients. The intervention demonstrated feasibility, acceptability, and use with a high proportion of patients who engaged in and perceived a benefit from using this technology.
authors.affiliation: Division of Gastroenterology, Hepatology & Nutrition, Stanford School of Medicine, Stanford, CA.
authors.forename: Rebecca B
authors.initials: RB
authors.lastname: McKenzie
authors.affiliation: Division of Gastroenterology, Hepatology & Nutrition, Stanford School of Medicine, Stanford, CA.
authors.forename: William E
authors.initials: WE
authors.lastname: Berquist
authors.affiliation: Division of Gastroenterology, Hepatology & Nutrition, Stanford School of Medicine, Stanford, CA.
authors.forename: Megan A
authors.initials: MA
authors.lastname: Foley
authors.affiliation: Division of Gastroenterology, Hepatology & Nutrition, Stanford School of Medicine, Stanford, CA.
authors.forename: K T
authors.initials: KT
authors.lastname: Park
authors.affiliation: Division of Gastroenterology, Hepatology & Nutrition, Stanford School of Medicine, Stanford, CA.
authors.forename: Jered E
authors.initials: JE
authors.lastname: Windsheimer
authors.affiliation: Division of Adolescent Medicine, Department of Pediatrics, Stanford School of Medicine, Stanford, CA.
authors.forename: Iris F
authors.initials: IF
authors.lastname: Litt
keywords: HIT; Liver Transplant; Participation; Self-care; Self-management; Text-messaging; adolescents; mHealth; mobile health