Text Messaging Effect on Adherence in Children With Inflammatory Bowel Disease.
Successful treatment of patients with inflammatory bowel disease (IBD) requires regular intake of medication. Nonadherence to treatment is associated with increased frequency of relapses, morbidity, and cost.



Pediatric patients with IBD taking oral medication and with access to text messaging (TM) services were included. Children were randomized by age, sex, medication administration responsibility (self vs parent), and disease activity (Pediatric Crohn Disease Activity Index or Pediatric Ulcerative Colitis Activity Index) into TM intervention and standard of care. Prospectively, the interventional group received 2-way TM reminders about medication administration. Failure to confirm intake by the patient resulted in a TM alert to the caregiver and weekly compliance reports were sent to patients, caregivers, and healthcare providers. Patients' medical records were reviewed and an adherence Morisky questionnaire completed at recruitment, 6 and 12 months.



A total of 51 children were randomized (21 TM and 30 control). The age, sex, diagnosis (ulcerative colitis/Crohn), activity index, ethnicity, insurance, and Morisky score at baseline were similar in both groups. Morisky score improved by 1 and 0.8 points, respectively in the TM group at 6 and 12 months, whereas it did not change in the control group (P = 0.0131 and P = 0.1687, prospectively).



TM may be effective in promoting adherence in children with IBD. Larger and longer multicenter studies are required to confirm this finding.
*Baylor College of Medicine, Texas Children's Hospital, Houston, TX †Phoenix Children's Hospital, University of Arizona, Phoenix, Arizona.
Tamir
T
Miloh
Mitchell
M
Shub
Ramon
R
Montes
Kristy
K
Ingebo
Gary
G
Silber
Brad
B
Pasternak
D000284:Administration, Oral; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D002648:Child; D003093:Colitis, Ulcerative / Q000188:drug therapy* / Q000523:psychology; D003424:Crohn Disease / Q000188:drug therapy* / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology; D010865:Pilot Projects; D011446:Prospective Studies; D017010:Reminder Systems; D060145:Text Messaging; D016896:Treatment Outcome; D016903:Drug Monitoring
D000893:Anti-Inflammatory Agents