Morton Robert W, Elphick Heather E, Edwards Elaine, Daw William J, West Noreen S
Cystic Fibrosis Unit, Sheffield Children's Hospital.
Academic Unit of Child Health, University of Sheffield, Sheffield, UK.
Patient Prefer Adherence. 2017 May 8;11:861-869. doi: 10.2147/PPA.S123723. eCollection 2017.
Children with cystic fibrosis (CF) often have suboptimal adherence rates to nebulized medication. Adherence barriers cited include forgetting to take the nebulizers, due to busy home and social lives. Text message reminders have been shown to be effective at improving adherence rates in other chronic diseases such as asthma and diabetes.
The objective of this study was to assess the feasibility and efficacy of sending text reminders for a prolonged period of time to children with CF.
Children with CF aged 5-16 years taking at least one medication via a nebulizer with an electronic adherence monitor were consented for the study. Text message reminders were sent to participants and/or parents via the hospital's automated text service, up to twice a day, for 6 months. The adherence rates for the 6-month text period were compared to the previous 6 months before the study. Rates were calculated for weekdays, weekends, and school holidays.
Seventeen participants were recruited to the study, with a mean age of 12 years and a mean forced expiratory volume in 1 second (FEV1) of 81% predicted. Fifteen children completed the 6-month text period, and I-neb data were accurately analyzed for 13 participants. The mean adherence rate in the 6 months receiving texts was 80%, compared to 81% in the prior 6 months. Overall adherence rates on weekdays, weekends, and school holidays were equivalent during the 2 time periods. A subgroup of patients with moderate baseline adherence showed increased adherence during the text period, particularly at weekends.
It is feasible to send text message reminders to children with CF, and they are amenable to this approach. Although text reminders do not increase rates in patients with existing optimal adherence, they may be of value in patients with more moderate baseline rates.
囊性纤维化（CF）患儿对雾化药物的依从率往往不理想。所提及的依从障碍包括因家庭和社交生活繁忙而忘记使用雾化器。短信提醒已被证明在提高哮喘和糖尿病等其他慢性病的依从率方面有效。
本研究的目的是评估向CF患儿长期发送短信提醒的可行性和有效性。
年龄在5至16岁、通过雾化器服用至少一种药物且配备电子依从性监测器的CF患儿同意参与本研究。通过医院的自动短信服务向参与者和/或家长发送短信提醒，每天最多两次，持续6个月。将6个月短信期的依从率与研究前的前6个月进行比较。计算工作日、周末和学校假期的依从率。
17名参与者被纳入研究，平均年龄为12岁，1秒用力呼气容积（FEV1）平均为预测值的81%。15名儿童完成了6个月的短信期，对13名参与者的I-neb数据进行了准确分析。接受短信的6个月内平均依从率为80%，而前6个月为81%。两个时间段内工作日、周末和学校假期的总体依从率相当。一组基线依从性中等的患者在短信期内依从性增加，尤其是在周末。
向CF患儿发送短信提醒是可行的，他们也适合这种方法。虽然短信提醒不会提高现有依从性最佳的患者的依从率，但可能对基线依从率较为中等的患者有价值。
