Text Messages as a Reminder Aid and Educational Tool in Patients with Atopic Dermatitis

Research Objective

Our goals were to assess the usability and satisfaction of the text message system, and measure changes in pre- and post-test scores in medication adherence, maintenance behaviors, and disease severity. 

Drivers

Optimal management of atopic dermatitis (AD) requires patients to adhere to medications and to other behaviors, such as using emollients on a regular basis and avoiding skin irritants.  Evidence to date suggests that adherence to care plans is poor amongst dermatology patients. Technologies, such as cell phones, have been widely adopted in the US and could potentially be used to promote positive health behaviors.  The use of cell phone technology in the care of AD patients has not previously been studied. 

Program Overview

We conducted a pilot study with 20 adolescents and adults ages 14 years and older [mean 29.6 yrs, SD 13.6] with AD.  Daily text messages were sent for six weeks to participants with AD reminding them to use their medication and providing educational information about AD.  Our goals were to: 1) Assess the usability and satisfaction of the text message system, and 2) Measure changes in pre- and post-test scores in medication adherence, maintenance behaviors, and disease severity.  Self-reported medication adherence and maintenance behaviors were assessed via surveys at the beginning and end of the six weeks.  The post-study survey also assessed usability and satisfaction of the text message system.  Disease severity was assessed before and after the text message intervention by using the SCORing Atopic Dermatitis (SCORAD) index.  

Results

85% of participants found the text messages that reminded them to use their medication helpful, and 90% reported that the AD educational information provided to them via text message was helpful as well.  80% of participants reported that they would like to keep using the text message system, and 85% reported they would recommend it to a friend. 80% of participants reported an increase in the number of days a week they were adherent to their medical treatment (pre-study mean 3.7 days, SD 2.4; post study mean 6.1 days, SD 1.7).  In addition, 95% of participants reported an improvement of at least one health maintenance behavior.  Finally, the post-study SCORAD score decreased in 70% of participants (mean decrease 7.3 points, SD 4.0), suggesting an improvement in disease severity.

Study participants were receptive to using text messages as a reminder aid and educational tool. The positive trends observed with regard to various outcome measures is promising and lays the ground work for further studies, which are needed to elucidate the full potential of this simple and cost-effective intervention.

This study was published in:
Dermatology Research and Practice Volume 2010 (2010), Article ID 894258