title: Utilizing a Novel Mobile Health "Selfie" Application to Improve Compliance to Iron Chelation in Pediatric Patients Receiving Chronic Transfusions.
abstract: Iron chelation therapy can prevent iron overload for pediatric patients with sickle cell disease and β-thalassemia major; however, adherence is suboptimal. Therefore, we developed an intensive training program (ITP), to improve medication management and disease knowledge. The objectives were to determine feasibility of the ITP and its preliminary impact on adherence, disease knowledge, and health outcomes. Pediatric patients were recruited to participate in the ITP over a 90-day period and were followed for 6 months. The ITP consisted of 3 components: (1) provider-led education modules; (2) patient recording daily videos of at-home medication administration; and (3) provider feedback through video messages through the ITP app. Eleven patients participated (mean=12.4 y). Initially, patients endorsed high satisfaction and ease of use and tracked their medication usage 81% (24 out of 30) of days. At 90 days, adherence rates remained consistent (80%) and disease knowledge retention was high (96%). At 6 months, participants exhibited a clinically relevant decrease in serum ferritin, which trended toward statistical significance (P=0.068). Medication possession ratio did not significantly increase (0.65 to 0.72; not significant). The mobile ITP was feasibly implemented in a clinical setting; in addition, high levels of compliance, disease knowledge retention, and acceptance encourage larger studies evaluating mobile health technology to improve child health parameters.
authors.affiliation: *Department of Pediatrics, Duke University Medical Center †Department of Psychology and Neuroscience, Duke University, Durham, NC ‡School of Medicine, University of Pittsburgh, Pittsburgh, PA.
authors.forename: Sarah
authors.initials: S
authors.lastname: Leonard
authors.forename: Lindsay M
authors.initials: LM
authors.lastname: Anderson
authors.forename: Jude
authors.initials: J
authors.lastname: Jonassaint
authors.forename: Charles
authors.initials: C
authors.lastname: Jonassaint
authors.forename: Nirmish
authors.initials: N
authors.lastname: Shah
mesh_terms: D000293:Adolescent; D001803:Blood Transfusion; D015913:Chelation Therapy / Q000379:methods*; D002648:Child; D004493:Education; D005260:Female; D006801:Humans; D007502:Iron Chelating Agents; D008297:Male; D010349:Patient Compliance; D010353:Patient Education as Topic; D063046:Patient Medication Knowledge; D010865:Pilot Projects; D014741:Video Recording; D055815:Young Adult
chemical_list: D007502:Iron Chelating Agents