WS16.6 The Nebtext study: text message reminders to improve adherence to nebulised medication in children with cystic fibrosis

WS16.6 The Nebtext study: text message reminders to improve adherence to nebulised medication in children with cystic fibrosis

Oral Presentations / Journal of Cystic Fibrosis 15 (2016) S1–S50 Methods: Patients were asked to rank their views across 3 areas; ECR functionality t...

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Oral Presentations / Journal of Cystic Fibrosis 15 (2016) S1–S50

Methods: Patients were asked to rank their views across 3 areas; ECR functionality they valued; preferences for access to their ECR; information they would like to send to their ECR. Each question was classified as very important (1); important (2); quite important (3); ordinary (4); not important (5); very unimportant (6). Differences between categories were analysed using Chi2 [significant (p < 0.05*) and highly significant (p < 0.001**)]. Results: A questionnaire was completed by 160 patients, age 29.6 (±9.6) years. Conclusion: Access to physiological data, weight and medications was most important for patients. The ability to send prescription/reatment requests, advanced directives and intentions for organ donation were also high priority. Access to on-line health information was less important. These results underpin the implementation of patient access to their ECR and the on-line tracking of prescription data. Table: Patients’ ranking of ECR aspects Classification by patients (n)

Functionality Lung function Weight List of medications Sputum results Blood results Allergies Alert for due tests Bone results Links to healthcare websites Preference for access to their ECR Lung function chart CRP chart Weight chart List of current medications Access sputum results Access blood results Access drug allergies View Genetics Appointment and screening reminders View appointments View consultation details Dates iv antibiotic treatment Vitamin levels Clinic letters to GP Bone scan results Date/type vaccination Date last admission Referral to departments Patient views on information they can Request repeat prescriptions Add lung function measures Order treatment Add weight measures Add donor wishes Add advanced directives Complete pre-clinic interview Schedule appointments Add blood glucose readings Add oxygen saturation levels Add symptom diaries Add food/enzyme diary Add mood/feelings diary Add exercise diary Add blood pressure readings Add pain scales Completion of QOL measure

1

2

3

4

5

6

p-value

134 78 75 87 79 63 47 33 11

18 56 68 52 59 51 68 60 27

1 9 10 12 11 19 25 37 42

4 9 3 6 7 17 16 20 51

1 6 2 1 2 8 0 5 19

1 2 1 1 1 1 2 3 8

p < 0.001 p < 0.001 p < 0.001 p < 0.001 p < 0.001 p < 0.001 p < 0.001 p < 0.001 p < 0.001

1 1 2 2 1 0 6 7 0 4 0 6 2 5 3 5 7 5

1 1 2 2 2 2 3 5 2 2 2 5 3 3 2 2 6 1

p < 0.001 p < 0.001 p < 0.001 p < 0.001 p < 0.001 p < 0.001 p < 0.001 p < 0.001 p < 0.001 p < 0.001 p < 0.001 p < 0.001 p < 0.001 p < 0.001 p < 0.001 p < 0.001 p < 0.001 p < 0.001

6 6 6 4 7 10 7 2 8 11 8 9 18 13 12 13 8

2 4 1 4 7 4 6 2 6 4 40 6 9 5 4 6 10

p < 0.001 p < 0.001 p < 0.001 p < 0.001 p < 0.001 p < 0.001 p < 0.001 p < 0.001 p < 0.001 p < 0.001 p < 0.001 p < 0.001 p < 0.001 p < 0.001 p < 0.001 p < 0.001 p < 0.001

90 90 88 74 70 68 60 48 58 50 49 37 36 35 33 33 31 25 send 85 74 72 66 58 45 45 42 40 39 36 26 24 22 28 28 22

41 20 6 41 20 6 41 18 9 52 21 8 59 13 15 59 17 14 45 31 15 44 31 25 61 28 10 59 26 19 64 26 19 55 31 26 63 32 24 58 26 33 61 39 21 55 36 27 46 41 29 59 42 28 to their ECR 49 9 7 41 20 14 53 11 13 47 22 15 38 26 19 40 36 16 50 30 19 75 28 10 56 29 20 51 35 19 61 34 17 44 41 33 40 40 28 55 41 23 47 48 20 38 42 3 39 54 25

S27

WS16.5 Website based educational program on cystic fibrosis (CF) for community physicians T. Pugatsch1 , M. Cohen-Cymberknoh1 , H. Elyashar-Earon1 , I. Eisenstadt1 , M. Wilschanski1 , O. Breuer1 , S. Kurz1 , S. Palmor1 , S. Armoni1 , E. Kerem1 . 1 Hadassah-Hebrew University Medical Center, Pediatrics & CF Center, Jerusalem, Israel Objectives: Increased awareness to typical and atypical symptoms and signs of Cystic fibrosis among community physicians and healthcare providers is essential for early diagnosis. This is critical also in countries with newborn screening programs since false negative results do occur and therefore these patients will only be diagnosed when symptoms develop. To this purpose education is fundamental. The primary objective of the current program is to raise the awareness of community physicians to early symptoms of CF. Methods: An educational website based on the training modules that were previously developed in the Hadassah CF Center was created. The entire presentation is available as a video. Slides were divided into information for physicians and/or for nurses in the Mother and Child Health Care Centers (MCH). Accompanying explanations are currently available in English, Hebrew and Arabic. Search engine optimization (SEO) was applied to increase the accessibility of the website. Results: An easily to understand presentation was produced that will give community physicians the basics to understand the diagnosis, treatment and maintenance of CF patients. Conclusion: Higher awareness of community physicians to the possibility of CF will lead to earlier referrals, prior to pulmonary damage to the patient. WS16.6 The Nebtext study: text message reminders to improve adherence to nebulised medication in children with cystic fibrosis R.W. Morton1 , H.E. Elphick1 , N.S. West1 , W.J. Daw1 , E.S. Edwards1 . 1 Sheffield Childrens Hospital, Cystic Fibrosis Unit, Sheffield, United Kingdom Objectives: Children with cystic fibrosis often have sub-optimal adherence rates to nebulised medication. Adherence barriers cited include forgetting to take the nebulisers, 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 of sending text reminders for a prolonged period of time to children with CF, and to see if adherence rates to nebulised medication could be improved using this approach. Methods: Children with CF aged 5–16 years taking at least one medication via the I-neb (Philips Respironics) 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 downloaded and compared to the previous 6 months before the study. Rates were calculated for weekdays, weekends, and school holidays. Results: 17 participants were recruited to the study, with a mean age of 12 years and a mean FEV1 of 83% predicted. 15 completed the 6 month text period, I-neb data was accurately analysed for 13 participants. The mean adherence rate in the 6 months receiving texts was 79%, compared to 80% in the prior 6 months. There was no difference in rates for weekdays, weekends, or school holidays. Conclusion: It is feasible to send text message reminders to children with CF, and they are amenable to this approach. However, our results would suggest that text reminders alone are not an effective way of improving adherence rates to nebulised medication.