The Pediatric Heart Transplant Program at NewYork-Presbyterian/Morgan Stanley Children's Hospital is launching a one-year program that will use a text messaging platform to increase medication adherence in its teenage heart transplant patients.
The hospital is working with CareSpeak Communications Inc., a privately held mobile health company in New Jersey, which is providing the two-way technology system that will send the medication alerts to the patients.
Transplant patients are required to follow very strict medication regimens to prevent their bodies from rejecting the “foreign object.” Patients often must take immunosuppressants every day, multiple times per day, for as long as they live. Failing to do so can result in hospitalization, the need for a re-transplant, and even death.
The problem of medication non-adherence is especially challenging with the teen population. According to the journal Pediatric Transplantation non-adherence is the most common cause of organ rejection in long-term transplant patients, and adolescents are in the most high-risk category. Studies have shown that more than half of all teenage liver transplant recipients are non-adherent, and they are four times more likely than adult patients to take their medications at the wrong time or to forget to take them at all.
“Despite extensive educational programs for families and pediatric heart transplant recipients, significant medication noncompliance still occurs with alarming frequency, particularly with adolescents, which can prove deadly,” said Linda Addonizio, the director of the program for Pediatric Cardiomyopathy Heart Failure and Transplantation at NewYork-Presbyterian/Morgan Stanley Children’s Hospital. ”The outlook for long-term survival in non-compliant patients can be as low as 30 percent, compared to 90 percent survival in compliant pediatric heart transplant recipients.”
Caregivers involved in the program will receive a text alert that will say for example, “Joe it’s 8:15am, time to take 1 pill Prograf 1mg. Press REPLY, enter CARE 1 and press SEND”. In the case of older children who have their own cell phone, the text message is sent to them directly. If the patient doesn’t confirm medication intake within a pre-determined amount of time (e.g. 30 minutes), a follow up escalation text alert is sent to as many as two caregivers, alerting them that the patient didn’t report taking their medication. The caregiver message includes the patient’s cell phone number allowing for immediate response.
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