Rice Bria, Perin Jamie, Huettner Steven, Butz Arlene, Yusuf Hasiya E, Trent Maria
Department of Internal Medicine, Mayo Clinic, Phoenix, Arizona, USA.
Division of Adolescent and Young Adult Medicine, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD 21287, USA.
Pediatr Neonatal Nurs. 2022;8(1):14-24. doi: 10.17140/pnnoj-8-135. Epub 2022 Mar 30.
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.
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.
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, <0.001).
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.
本研究评估患者对用于盆腔炎（PID）自我护理支持的自动短信系统的反应，并测量通过短信报告的依从性的可靠性。
从城市学术门诊机构招募年龄在13至25岁之间患有轻度至中度PID的患者。入选患者接受抗生素治疗，并被随机分为标准护理组或干预组。在为期14天的治疗期间，干预组的参与者接受了一次社区护理访视以及每日短信用药提醒，并在晚上提示报告所服用的剂量数。
在随机分配到干预组的97名参与者中，91名（94%）符合分析条件。大多数是非洲裔美国人且收入较低，平均年龄为18.3（标准差=2.2）岁。参与者回复了所有剂量询问短信的约53%（标准差=34%）。在治疗期间，反应率每天约衰减2.2%。分析的干预组中有93%（n=85）返回进行为期两周的随访。尽管总体依从性和一般反应性良好，但通过短信报告的用药依从性和自我报告的用药依从性相关性不佳（r=0.37，<0.001）。
我们的研究结果表明，短信是在门诊环境中与接受复杂性传播感染治疗的城市青少年取得联系的可行策略。然而，患者对自我护理短信的反应确实存在差异，限制了该技术的依从性监测能力。鉴于未回复短信的数量以及短信报告的依从性数据不完整，在临床试验中需要采取额外措施来评估青少年对PID药物的依从性。
