Randomized pilot trial of praise text messages to improve medication adherence among adolescents and young adults with liver transplants
This article relates to:
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Positive reinforcement using praise text messaging: Can this be the way to optimize and maintain adherence behavior in teens with chronic conditions?
- Volume 26Issue 7Pediatric Transplantation
- First Published online: July 19, 2022
Corresponding Author
Caitlin Sayegh
Division of Adolescent and Young Adult Medicine, Children’s Hospital Los Angeles, Los Angeles, California, USA
USC University Center for Excellence in Developmental Disabilities, Children’s Hospital Los Angeles, Los Angeles, California, USA
University of Southern California Keck School of Medicine, Los Angeles, California, USA
Correspondence
Caitlin Sayegh, Children's Hospital Los Angeles, Sunset Blvd., MS#2, Los Angeles, CA 90027, USA.
Email: [email protected]
Search for more papers by this authorDeborah Im
University of Southern California Keck School of Medicine, Los Angeles, California, USA
Search for more papers by this authorIlana K. Moss
Division of Gastroenterology, Hepatology, and Nutrition, Children’s Hospital Los Angeles, Los Angeles, California, USA
Search for more papers by this authorRuby Urquiza
Division of Gastroenterology, Hepatology, and Nutrition, Children’s Hospital Los Angeles, Los Angeles, California, USA
Search for more papers by this authorShreena Patel
University of Southern California Keck School of Medicine, Los Angeles, California, USA
Division of Gastroenterology, Hepatology, and Nutrition, Children’s Hospital Los Angeles, Los Angeles, California, USA
Search for more papers by this authorDan W. Thomas
University of Southern California Keck School of Medicine, Los Angeles, California, USA
Division of Gastroenterology, Hepatology, and Nutrition, Children’s Hospital Los Angeles, Los Angeles, California, USA
Search for more papers by this authorCorresponding Author
Caitlin Sayegh
Division of Adolescent and Young Adult Medicine, Children’s Hospital Los Angeles, Los Angeles, California, USA
USC University Center for Excellence in Developmental Disabilities, Children’s Hospital Los Angeles, Los Angeles, California, USA
University of Southern California Keck School of Medicine, Los Angeles, California, USA
Correspondence
Caitlin Sayegh, Children's Hospital Los Angeles, Sunset Blvd., MS#2, Los Angeles, CA 90027, USA.
Email: [email protected]
Search for more papers by this authorDeborah Im
University of Southern California Keck School of Medicine, Los Angeles, California, USA
Search for more papers by this authorIlana K. Moss
Division of Gastroenterology, Hepatology, and Nutrition, Children’s Hospital Los Angeles, Los Angeles, California, USA
Search for more papers by this authorRuby Urquiza
Division of Gastroenterology, Hepatology, and Nutrition, Children’s Hospital Los Angeles, Los Angeles, California, USA
Search for more papers by this authorShreena Patel
University of Southern California Keck School of Medicine, Los Angeles, California, USA
Division of Gastroenterology, Hepatology, and Nutrition, Children’s Hospital Los Angeles, Los Angeles, California, USA
Search for more papers by this authorDan W. Thomas
University of Southern California Keck School of Medicine, Los Angeles, California, USA
Division of Gastroenterology, Hepatology, and Nutrition, Children’s Hospital Los Angeles, Los Angeles, California, USA
Search for more papers by this authorAbstract
Background
AYA who have undergone liver transplantations often struggle to adhere to their post-transplant immunosuppressant medications, which can lead to serious health complications. The objective of this pilot study is to examine the acceptability and feasibility of a brief mobile health (mHealth) intervention and its impact on medication adherence among AYA liver transplant recipients.
Methods
Thirty-five AYAs (13–21 years old) were randomized to either (1) receive praise text messages whenever laboratory results indicated immunosuppressant medications within the expected range or (2) usual care. Motivation for adherence and adherence were assessed via self-report, and a MLVI was calculated based on values abstracted from the electronic health record.
Results
Multilevel, multivariate models showed significant associations between group assignment and some self-reported motivation and adherence outcomes but not MLVI. Specifically, AYA receiving the praise text messages were significantly more likely to report taking their prescribed doses (OR = 2.49, p = .03), taking their medicine according to the directions (OR = 2.39, p = .04), and being highly confident in taking their medication (OR = 2.46, p = .04), compared with the usual services group. Qualitative responses indicated praise texts were mostly helpful but could be improved.
Conclusions
The results suggest texting patients about positive health indicators was acceptable and, with refinement, might promote AYA illness self-management.
Open Research
DATA AVAILABILITY STATEMENT
Data will be available to researchers on request subject to sponsor and IRB approval.
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