Improved hydroxyurea effect with the use of text messaging in children with sickle cell anemia

Jeremie H. Estepp, Bryan Winter, Margery Johnson, Matthew P. Smeltzer, Scott Howard, Jane S. Hankins

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Background: 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. Procedure: All patients <19 years of age with HbSS or HbSβ0thalassemia 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®. Results: 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. Conclusions: 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.

Original languageEnglish (US)
Pages (from-to)2031-2036
Number of pages6
JournalPediatric Blood and Cancer
Volume61
Issue number11
DOIs
StatePublished - Nov 1 2014
Externally publishedYes

Fingerprint

Text Messaging
Hydroxyurea
Sickle Cell Anemia
Cell Phones
Erythrocyte Indices
Medication Adherence
Hospitalization
Reticulocyte Count
Fetal Hemoglobin
Pediatric Hospitals
Bilirubin
Technology
Morbidity

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Hematology
  • Oncology

Cite this

Improved hydroxyurea effect with the use of text messaging in children with sickle cell anemia. / Estepp, Jeremie H.; Winter, Bryan; Johnson, Margery; Smeltzer, Matthew P.; Howard, Scott; Hankins, Jane S.

In: Pediatric Blood and Cancer, Vol. 61, No. 11, 01.11.2014, p. 2031-2036.

Research output: Contribution to journalArticle

Estepp, Jeremie H. ; Winter, Bryan ; Johnson, Margery ; Smeltzer, Matthew P. ; Howard, Scott ; Hankins, Jane S. / Improved hydroxyurea effect with the use of text messaging in children with sickle cell anemia. In: Pediatric Blood and Cancer. 2014 ; Vol. 61, No. 11. pp. 2031-2036.
@article{2a34d048eaf04b6797a597e31328dbd9,
title = "Improved hydroxyurea effect with the use of text messaging in children with sickle cell anemia",
abstract = "Background: 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. Procedure: All patients <19 years of age with HbSS or HbSβ0thalassemia 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{\circledR}) were retrospectively identified. Laboratory parameters, hospitalizations, and medication possession ratios (MPR) prior to and after initiation of SIMON{\circledR} were compared to assess the impact of SIMON{\circledR}. Results: 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{\circledR}. Following initiation of SIMON{\circledR}, 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{\circledR}, and medication possession ratios (MPRs) were high before and after SIMON{\circledR}, neither was significantly changed. Conclusions: SIMON{\circledR} 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.",
author = "Estepp, {Jeremie H.} and Bryan Winter and Margery Johnson and Smeltzer, {Matthew P.} and Scott Howard and Hankins, {Jane S.}",
year = "2014",
month = "11",
day = "1",
doi = "10.1002/pbc.25177",
language = "English (US)",
volume = "61",
pages = "2031--2036",
journal = "Pediatric Blood and Cancer",
issn = "1545-5009",
publisher = "Wiley-Liss Inc.",
number = "11",

}

TY - JOUR

T1 - Improved hydroxyurea effect with the use of text messaging in children with sickle cell anemia

AU - Estepp, Jeremie H.

AU - Winter, Bryan

AU - Johnson, Margery

AU - Smeltzer, Matthew P.

AU - Howard, Scott

AU - Hankins, Jane S.

PY - 2014/11/1

Y1 - 2014/11/1

N2 - Background: 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. Procedure: All patients <19 years of age with HbSS or HbSβ0thalassemia 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®. Results: 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. Conclusions: 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.

AB - Background: 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. Procedure: All patients <19 years of age with HbSS or HbSβ0thalassemia 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®. Results: 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. Conclusions: 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.

UR - http://www.scopus.com/inward/record.url?scp=84922603278&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84922603278&partnerID=8YFLogxK

U2 - 10.1002/pbc.25177

DO - 10.1002/pbc.25177

M3 - Article

C2 - 25132074

AN - SCOPUS:84922603278

VL - 61

SP - 2031

EP - 2036

JO - Pediatric Blood and Cancer

JF - Pediatric Blood and Cancer

SN - 1545-5009

IS - 11

ER -