Study: Texting improves medication adherence in teens with diabetes

Jennifer Dyer, MD, MPH, endocrinologist at Nationwide Children's Hospital in Columbus, Ohio

A small pilot study at Nationwide Children's Hospital in Columbus, Ohio, found that sending text reminders to adolescent diabetes patients about their insulin treatments improved treatment adherence and blood glucose levels.

According to a 2010 report from the Pew Internet and American Life Project, half of teens send 50 or more text messages a day, or 1,500 texts a month, and one in three send more than 100 texts a day, or more than 3,000 texts a month.

Recognizing that text messaging was the primary mode of communication for her patients, Jennifer Dyer, MD, MPH, an endocrinologist at Nationwide Children's Hospital, developed the idea for the pilot as a way to help remind her teenage patients to take their insulin treatments. 

Studies have shown that adolescent patients have a greater difficulty adhering to treatment and medication activities than adults. Thus, there is a significant correlation between increased independence and decreased treatment adherence in adolescents. The rate of medication non-adherence among adolescent recipients is approximately four times higher than that among adult recipients.

This was a trend that Dyer reported seeing in her own patients, with most of them missing nine to eleven boluses per week, or the majority of their insulin treatments.

"If adolescent diabetes patients do not adhere to their treatment and medication plan, it can result in difficulty concentrating in school or functioning throughout the day," said Dyer. "Excellent control and treatment can have a long term positive effect on a patient with diabetes."

During the study, Dyer sent personalized questions and reminders specific to diabetes adherence activities in addition to friendly, supportive messages to her patients. By asking questions about glucose testing, meal boluses and frequency of high and low glucoses, Dyer said she saw an increase in teens taking their medications. After three months of sending text reminders she reported that they were three times less likely to miss a dose.

Due to the success of this study, Dyer has applied for an internal grant in order to test an iPhone application that she has developed. This application will allow endocrinologists to send personalized, automated texts to multiple patients at a specific time.

"This form of communication allows for real-time health management which is extremely valuable for patients that suffer from a chronic illness like diabetes," said Dyer.