McKenzie Rebecca B, Berquist William E, Foley Megan A, Park K T, Windsheimer Jered E, Litt Iris F
Division of Gastroenterology, Hepatology & Nutrition, Stanford School of Medicine, Stanford, CA.
Division of Adolescent Medicine, Department of Pediatrics, Stanford School of Medicine, Stanford, CA.
J Particip Med. 2015;7.
In solid organ transplant patients, non-participation in all aspects of the medical regimen is a prevalent problem associated with adverse consequences particularly in the adolescent and young adult (AYA) age group. This study is the first to evaluate the feasibility, utility and impact of a text messaging (TM) intervention to improve participation in laboratory testing in adolescent liver transplant patients.
AYA patients, aged 12 to 21 years, were recruited for a prospective pilot trial evaluating a TM intervention delivered over a 1-year period. The intervention involved automated TM reminders with feedback administered according to a prescribed laboratory testing frequency. Participation rate in laboratory testing after the intervention was compared to the year prior. Patient responses and feedback by text and survey were used to assess feasibility, acceptability and use of the intervention.
Forty-two patients were recruited and 33 patients remained enrolled for the study duration. Recipients of the TM intervention demonstrated a significant improvement in participation rate in laboratory testing from 58% to 78% (P<.001). This rate was also significantly higher than in non-intervention controls (P=.003). There was a high acceptability, response rate and a significant correlation with reported versus actual completion of laboratory tests by TM.
TM reminders significantly improved participation in laboratory testing in AYA liver transplant patients. The intervention demonstrated feasibility, acceptability, and use with a high proportion of patients who engaged in and perceived a benefit from using this technology.
在实体器官移植患者中，不参与整个医疗方案是一个普遍存在的问题，会带来不良后果，在青少年和青年（AYA）年龄组中尤为如此。本研究首次评估了短信（TM）干预对提高青少年肝移植患者实验室检查参与度的可行性、效用和影响。
招募年龄在12至21岁的AYA患者进行一项前瞻性试点试验，评估为期1年的TM干预。干预措施包括根据规定的实验室检查频率发送自动TM提醒并提供反馈。将干预后的实验室检查参与率与前一年进行比较。通过短信和调查收集患者的反应和反馈，以评估干预措施的可行性、可接受性和使用情况。
招募了42名患者，33名患者在研究期间持续参与。TM干预的接受者实验室检查参与率从58%显著提高到78%（P<.001）。该比率也显著高于非干预对照组（P=.003）。TM的可接受性、回复率较高，且与报告的实验室检查完成情况和实际完成情况之间存在显著相关性。
TM提醒显著提高了AYA肝移植患者的实验室检查参与度。该干预措施证明了其可行性、可接受性，并且大多数参与并认为使用该技术有益的患者都在使用。
