Improved hydroxyurea effect with the use of text messaging in children with sickle cell anemia. Issue 11 (17th August 2014)

• Record Type: Journal Article
• Authors: Estepp, Jeremie H.; Winter, Bryan; Johnson, Margery; Smeltzer, Matthew P.; Howard, Scott C.; Hankins, Jane S.
• Is Part Of: Pediatric blood & cancer. Volume 61:Issue 11(2014:Nov.)
• Page Start: 2031
• Page End: 2036
• Publication Date: 2014-08-17
• Subjects: Tumors in children -- Periodicals; Blood -- Diseases -- Periodicals; Cancer in children -- Periodicals; 618.92
• DOI: 10.1002/pbc.25177
• Languages: English
• ISSNs: 1545-5009

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="pbc25177-sec-0001" sec-type="section"> <title>Background</title> <p>In children with sickle cell anemia (SCA), hydroxyurea reduces morbidity, but adherence is frequently suboptimal. Because most families of children with SCA have access to cellular telephone services, we assessed the impact of text messaged reminders as a tool to improve adherence to hydroxyurea.</p> </sec> <sec id="pbc25177-sec-0002" sec-type="section"> <title>Procedure</title> <p>All patients <19 years of age with HbSS or HbSβ<sup>0</sup>thalassemia who were treated with hydroxyurea at a maximal tolerated dosage (MTD) at St. Jude Children's Research Hospital Comprehensive Pediatric Sickle Cell Program and who received automated text message reminders (SIMON®) were retrospectively identified. Laboratory parameters, hospitalizations, and medication possession ratios (MPR) prior to and after initiation of SIMON® were compared to assess the impact of SIMON®.</p> </sec> <sec id="pbc25177-sec-0003" sec-type="section"> <title>Results</title> <p>Of the 97.3% of families with access to a cell phone, 91% elected to receive text message reminders. Among 55 children receiving hydroxyurea at MTD, laboratory parameters reflected waning medication compliance during the 12 months prior to SIMON®. Following initiation of SIMON®, children had higher mean corpuscular volumes, hemoglobin levels and fetal hemoglobin percentages and lower absolute reticulocyte counts and bilirubin levels, suggesting improved medication adherence. Hospitalizations were uncommon before and after SIMON®, and medication possession ratios (MPRs) were high before and after SIMON®, neither was significantly changed.</p> </sec> <sec id="pbc25177-sec-0004" sec-type="section"> <title>Conclusions</title> <p>SIMON® was feasible and improved hematologic parameters in children with SCA receiving hydroxyurea at a MTD. Future work will include extension of this technology to children with other chronic medical conditions who require daily use of medication. Pediatr Blood Cancer 2014;61:2031–2036. © 2014 Wiley Periodicals, Inc.</p> </sec> </abstract>