Nagging via text messages to help teens remember meds

WASHINGTON -- 4gt yr meds? Getting teens to remember their medicine may be a text message away.

Cincinnati doctors are experimenting with texting to tackle a big problem: Tweens and teens too often do a lousy job of controlling chronic illnesses like asthma, diabetes or kidney disease.

It's a problem long recognized in adults, particularly for illnesses that can simmer without obvious symptoms until it's too late. But only now are doctors realizing how tricky a time adolescence is for skipping meds, too.

Of necessity, parents start turning over more health responsibilities to their children at this age. It's also an age of angst, sometimes rebellion, and when youths may most hate feeling different from their friends because of medication, special diets or other therapy.

"It's a time of so much change in these kids' lives," said Dr. Marva Moxey-Mims, a specialist in pediatric kidney disease at the National Institutes of Health. "It's very difficult when you've got a life-threatening illness to say, 'Let them make their mistakes.'"

Some studies suggest only half of adolescents, on average, properly follow treatment steps, says Dr. Dennis Drotar of Cincinnati Children's Hospital. The more medications required or the more troublesome the side effects -- even, for appearance-conscious teens, such things as weight gain from steroid medications -- the worse teens adhere.

Even when parents try to keep close tabs, "kids are cunning," Drotar said. "Parents are in a bind because there's pushback."

Drotar once used a monitor to detect whether cystic fibrosis patients performed a chest-thumping therapy to clear their lungs. One teen's monitor showed weird readings: He'd strapped it onto his dog.

Kabrina Moton, 16, of Cincinnati knows she'll start wheezing and need her inhaler when she plays basketball if she hasn't taken her daily asthma pill.

Still, "one time I went a whole month without taking it," she confesses. "It's just work and school and being in and out of the house all the time. ... When I would think about it, I wasn't around it or I was out and I wouldn't remember later on."

Enter text messages.

Dr. Maria Britto, an asthma specialist at Cincinnati Children's, noticed that even when she's talking to adolescent patients perched on the clinic exam table, they'll keep texting on their cell phones.

"You have to get in their face a little," she said with a laugh.

But it sparked the idea for a study to see if a daily medication reminder via text message would improve teens' asthma control -- preventing full-blown attacks, improving school attendance and decreasing doctor and emergency-room visits. After all, Britto says youth as young as 12 carry the phones into her clinic, poor and middle class alike.

Pilot testing recently began, with a full study set for later this year. Participants say what time they want the reminder, and a clinic volunteer types out the messages -- words spelled out, no mimicking of teens' text lingo.

Moton said she texts a lot, so it's easy to spot her reminder at 7 each evening -- and so far, she hasn't missed a dose.

"It always says, 'Have a nice day,'" she said. "It makes me feel good about it."

If the simple reminders work for asthma, they may for other diseases, too.