Dataset Information

Can Automated Text Messaging Successfully Monitor Antibiotic Adherence for Urban Adolescents and Young Women Managed for Pelvic Inflammatory Disease in the Outpatient Setting.

ABSTRACT:

Objective

This study evaluates patient responsiveness to an automated text messaging system for pelvic inflammatory disease (PID) self-care support, and measures the reliability of text-reported adherence.

Design

Patients aged 13-25-years with mild to moderate PID were recruited from urban, academic outpatient settings. Enrolled patients received antibiotics and were randomized into a standard of care or intervention group. During a 14-day treatment period, participants in the intervention arm received a community-based nursing visit and daily text message medication reminders with evening prompts to report the number of doses taken.

Result

Of the 97 participants randomized into the intervention arm, 91 (94%) were eligible for analysis. Most were African American and low income, with a mean age of 18.3 (SD=2.2) years. Participants responded to ~53% (SD=34%) of all dosage inquiry messages. Responsiveness attenuated at approximately 2.2% per day over the treatment period. Ninety-three percent (n=85) of the analyzed intervention arm returned for the two-week follow-up. Despite overall adherence and general responsiveness, text-reported and self-reported medication adherence were not well correlated (r=0.37, p<0.001).

Conclusion

Our findings show that text messaging is a feasible strategy for reaching urban adolescents being managed for complicated sexually transmitted infections in outpatient settings. However, patient responsiveness to self-care text messages do vary, limiting the adherence monitoring capacity of this technology. Given the number of unanswered text messages and incomplete text-reported adherence data, additional measures to assess adolescents' adherence to PID medications are needed in clinical trials.

SUBMITTER: Rice B

PROVIDER: S-EPMC10664842 | biostudies-literature | 2022

REPOSITORIES: biostudies-literature

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Publications

Can Automated Text Messaging Successfully Monitor Antibiotic Adherence for Urban Adolescents and Young Women Managed for Pelvic Inflammatory Disease in the Outpatient Setting.

Rice Bria B Perin Jamie J Huettner Steven S Butz Arlene A Yusuf Hasiya E HE Trent Maria M

Pediatrics and neonatal nursing : open journal 20220330 1

<h4>Objective</h4>This study evaluates patient responsiveness to an automated text messaging system for pelvic inflammatory disease (PID) self-care support, and measures the reliability of text-reported adherence.<h4>Design</h4>Patients aged 13-25-years with mild to moderate PID were recruited from urban, academic outpatient settings. Enrolled patients received antibiotics and were randomized into a standard of care or intervention group. During a 14-day treatment period, participants in the int ...[more]

PMID: 37994348

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Project description:BACKGROUND:Mobile phone text messaging (SMS) has the potential to promote adherence to tuberculosis treatment. This systematic review aims to synthesize current evidence on the effectiveness of SMS interventions in improving patients' adherence to tuberculosis treatment. METHODS:We searched electronic databases (PubMed, EMBASE, Science Citation Index), reference lists of relevant articles, conference proceedings, and selected websites for eligible studies available by 15 February 2013; regardless of language or publication status. Two authors independently screened selected eligible studies, and assessed risk of bias in included studies; resolving discrepancies by discussion and consensus. RESULTS:We identified four studies that compared the outcomes of the SMS intervention group with controls. Only one of the four studies was a randomized controlled trial. This was conducted in Argentina and the SMS intervention did not significantly improve adherence to tuberculosis treatment compared to self-administration of tuberculosis treatment (risk ratio [RR] 1.49, 95% confidence intervals [CI] 0.90 to 2.42). One of the non-randomized studies, conducted in South Africa, which compared SMS reminders to directly observed therapy short course (DOTS) reported similar rates of tuberculosis cure (62.35% vs. 66.4%) and treatment success (72.94% vs. 69.4%). A second study from South Africa, utilized SMS reminders when patients delayed in opening their pill bottles and reported increased tuberculosis cure (RR 2.32, 95% CI 1.60 to 3.36) and smear conversion (RR 1.62, 95% CI 1.09 to 2.42) rates compared to DOTS. In the third non-randomized study, conducted in Kenya, use of SMS reminders increased rates of clinic attendance on scheduled days compared to standard care (RR 1.56, 95% CI 1.06 to 2.29). Using the GRADE approach, we rate the quality of the evidence as low, mainly because of the high risk of bias and heterogeneity of effects across studies. CONCLUSIONS:This systematic review indicates that there is a paucity of high-quality data on the effectiveness of SMS interventions for improving patients' adherence to tuberculosis treatment. The low quality of the current evidence implies that further studies (in particular randomized trials) on the subject are needed. In the interim, if the intervention is implemented outside research settings an impact evaluation is warranted.

Project description:BackgroundAlthough most patients with SARS-CoV-2 infection can be safely managed at home, the need for hospitalization can arise suddenly.ObjectiveTo determine whether enrollment in an automated remote monitoring service for community-dwelling adults with COVID-19 at home ("COVID Watch") was associated with improved mortality.DesignRetrospective cohort analysis.SettingMid-Atlantic academic health system in the United States.ParticipantsOutpatients who tested positive for SARS-CoV-2 between 23 March and 30 November 2020.InterventionThe COVID Watch service consists of twice-daily, automated text message check-ins with an option to report worsening symptoms at any time. All escalations were managed 24 hours a day, 7 days a week by dedicated telemedicine clinicians.MeasurementsThirty- and 60-day outcomes of patients enrolled in COVID Watch were compared with those of patients who were eligible to enroll but received usual care. The primary outcome was death at 30 days. Secondary outcomes included emergency department (ED) visits and hospitalizations. Treatment effects were estimated with propensity score-weighted risk adjustment models.ResultsA total of 3488 patients enrolled in COVID Watch and 4377 usual care control participants were compared with propensity score weighted models. At 30 days, COVID Watch patients had an odds ratio for death of 0.32 (95% CI, 0.12 to 0.72), with 1.8 fewer deaths per 1000 patients (CI, 0.5 to 3.1) (P = 0.005); at 60 days, the difference was 2.5 fewer deaths per 1000 patients (CI, 0.9 to 4.0) (P = 0.002). Patients in COVID Watch had more telemedicine encounters, ED visits, and hospitalizations and presented to the ED sooner (mean, 1.9 days sooner [CI, 0.9 to 2.9 days]; all P < 0.001).LimitationObservational study with the potential for unobserved confounding.ConclusionEnrollment of outpatients with COVID-19 in an automated remote monitoring service was associated with reduced mortality, potentially explained by more frequent telemedicine encounters and more frequent and earlier presentation to the ED.Primary funding sourcePatient-Centered Outcomes Research Institute.

Dataset Information

Can Automated Text Messaging Successfully Monitor Antibiotic Adherence for Urban Adolescents and Young Women Managed for Pelvic Inflammatory Disease in the Outpatient Setting.

Objective

Design

Result

Conclusion

Publications

Can Automated Text Messaging Successfully Monitor Antibiotic Adherence for Urban Adolescents and Young Women Managed for Pelvic Inflammatory Disease in the Outpatient Setting.

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