title: Improving Adolescent Pelvic Inflammatory Disease Follow-up From the Emergency Department: Randomized Controlled Trial With Text Messages.
abstract: Centers for Disease Control and Prevention guidelines recommend follow-up within 72 hours of diagnosis of pelvic inflammatory disease because patients with inadequate treatment are at increased risk of acute and chronic complications. Follow-up rates in adolescents after diagnosis range between 10% and 16%. The primary objective is to assess the effect of text message reminders to adolescent patients receiving a diagnosis of pelvic inflammatory disease on obtaining follow-up care within 72 hours of emergency department (ED) discharge.
  
  
  
  This was a single-blinded randomized controlled trial of adolescents receiving a diagnosis of pelvic inflammatory disease in the ED. Patients received standard discharge instructions or standard discharge instructions plus text message reminders. Patients in the text message group received daily, tailored text messages for 4 days, with a reminder to schedule and attend primary care provider follow-up. The primary outcome was follow-up within 72 hours of ED discharge.
  
  
  
  Ninety-five patients (48 standard; 47 text message) were randomized. Three patients were excluded, leaving 92 patients (46 standard; 46 text message) for analysis. Baseline characteristics were similar between treatment groups. Follow-up was 15.2% in the standard group and 43.5% in the text message group. Patients receiving text message reminders were more likely to follow up compared with the standard group (relative risk 2.9; 95% confidence interval [CI] 1.4 to 5.7). The absolute efficacy difference was 28.3% (95% CI 9.5% to 46.9%), yielding number needed to treat of 4 (95% CI 2.2 to 9.5).
  
  
  
  Personalized text message reminders were efficacious in improving follow-up for adolescents after ED diagnosis of pelvic inflammatory disease.
authors.affiliation: Departments of Pediatrics and Emergency Medicine, University of Michigan, Ann Arbor, MI. Electronic address: wolffm@med.umich.edu.
authors.forename: Margaret
authors.initials: M
authors.lastname: Wolff
authors.affiliation: Children's Hospital of Philadelphia, Division of Emergency Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA.
authors.forename: Fran
authors.initials: F
authors.lastname: Balamuth
authors.affiliation: Texas Children's Hospital, Section of Emergency Medicine, Baylor College of Medicine, Houston, TX.
authors.forename: Esther
authors.initials: E
authors.lastname: Sampayo
authors.affiliation: Children's Hospital of Philadelphia, Division of Emergency Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA.
authors.forename: Cynthia
authors.initials: C
authors.lastname: Mollen
mesh_terms: D000293:Adolescent; D016497:Adolescent Health Services; D001071:Appointments and Schedules; D019091:Critical Pathways; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D005260:Female; D006801:Humans; D000292:Pelvic Inflammatory Disease / Q000517:prevention & control*; D058996:Quality Improvement; D017010:Reminder Systems / Q000295:instrumentation*; D016037:Single-Blind Method; D060145:Text Messaging