Question of the Week

June 19 2008


It seems that there are always news reports about cell phones and teens that focus on the negative. Whether it be a car accident when a teen was talking on the phone, or a case in Spain which some fear is the hint of a larger problem when it comes to teens and cell phone addiction.

"Two children in Spain have been admitted to a mental health institution to be treated for addiction to their mobile phones, Spanish media report. The children, aged 12 and 13, were sent to the clinic by their parents, who said they could not carry out normal activities without their handsets. They were doing badly at school and lying to relatives in order to get money to spend on their phones. They have been learning to cope without their phones for three months. Dr Maite Utges, who runs the Child and Youth Mental Health Centre in Lleida, near Barcelona in north-eastern Spain, said it was the first time the clinic had treated children who were dependent on their mobile phones. 'They both showed disturbed behaviour and this exhibited itself in failure at school. They both had serious difficulties leading normal lives,' she was quoted in Spanish papers as saying. ... He warned these cases could be the 'tip of the iceberg', and that mobile phone addiction 'could definitely be a danger in the future'. Fears have been raised in a number of countries about the adverse effects mobile phone use may have on children."

Cell phones have become an integral part of the lives of many teens. While this can create issues, some doctors are trying to use the popularity of cell phones as a solution to problem that they have been fighting for years.

"Cincinnati doctors are experimenting with texting to tackle a big problem: Tweens and teens too often do a lousy job of controlling chronic illnesses like asthma, diabetes or kidney disease. It's a problem long recognized in adults, particularly for illnesses that can simmer without obvious symptoms until it's too late. But only now are doctors realizing how tricky a time adolescence is for skipping meds, too. Of necessity, parents start turning over more health responsibilities to their children at this age. It's also an age of angst, sometimes rebellion, and when youths may most hate feeling different from their friends because of medication, special diets or other therapy. ...

  • Some studies suggest only half of adolescents, on average, properly follow treatment steps, says Dr. Dennis Drotar of Cincinnati Children's Hospital. The more medications required or the more troublesome the side effects...
  • Asthma's record is particularly bad, with research suggesting as few as 30 percent of teenagers correctly take medication to prevent asthma attacks.
  • Among kidney transplant recipients, adolescents have the worst long-term outcomes of any age group, says Moxey-Mims...."

With tweens and teens taking more responsibility for their own medications, and chronic illnesses so easy for people to ignore before serious problems have developed, doctors are trying to use texting as a way to reach teens with chronic asthma and help them remember to take their medications. So far, it seems to be helping.

"Pilot testing recently began, with a full study set for later this year. Participants say what time they want the reminder, and a clinic volunteer types out the messages -- words spelled out, no mimicking of kids' text lingo. Moton [a teenager who was frequently skipping her daily asthma medication] says she texts a lot, so it's easy to spot her reminder at 7 each evening -- and so far, she hasn't missed a dose. 'It always says, "Have a nice day,"' she says. 'It makes me feel good about it.' If the simple reminders work for asthma, they may for other diseases, too."

While doctors in the U.S. are experimenting with the prospect of using text messaging to help teens remember their medications, doctors in South Africa are already using text messaging to reach adult patients with TB (tuberculosis).

"World Health Organisation rules state that all TB sufferers have to be observed by a doctor to ensure they take their medication. For many this means time-consuming daily trips to a health centre. But Avril, along with 60 other TB sufferers in Cape Town, is different. They are part of a small but significant revolution which has been made possible by mobile phone text messaging services. Instead of making those daily trips to her local clinic she is allowed to take her medication at home. ... 'I receive my SMS every day at two o'clock which tells me to take my medication, which is what I do,' said Avril. 'It means I don't have to go the clinic any more which was very inconvenient.' The message in English, Afrikaans or Xhosa is sent at a specified time on 22 days of each month over a period of six months. To begin with, it was straightforward reminding patients to take their medication. But patients complained it was not engaging enough. Now each reminder comes with TB information, lifestyle hints and a joke on Fridays. 'You get a lot of different type of messages,' said Avril, 'like "Did you Know Nelson Mandela had TB" or "Beware TB is contagious". They keep you informed and mean you never forget to take your drugs.'"

Further research is currently underway to use texting and free cell phone minutes to keep TB patients accountable.

"Now a student-led group at the Massachusetts Institute of Technology has developed a way to use cell phones to let patients test themselves. And if the tests show patients are following doctor's orders, they get rewarded with free minutes. ... The system works like this: Patients test their urine using a strip that reveals a numeric code if it detects TB medicine. They then text message the code to their health care provider and get credit toward incentives such as free minutes. The in-home tests also eliminate the need for health care workers to make several patient-monitoring visits a week, a routine that is often impractical in remote places, Gomez-Marquez said. Mobile phones are good tools for the project because they are common in the developing world, where it's often cheaper to erect cell towers than miles of poles and wires."

Even without a texting service (or the hope of free minutes) teens can use alarm features on their cell phones to remind them of daily medications needed for chronic illnesses -- or to help them remember to take an antibiotic every four hours when they have a prescription for a couple of weeks.

Questions of the Week:
How can those with cell phones currently use them to help manage short-term and long-term medications? In what ways do you think these experimental programs might help you, your peers, or your family members who need to take medications on a regular basis? What other ways can you think of that cell phones could be used to help tweens, teens, and adults make decisions that will benefit their health?

Please email me with any ideas or suggestions.
Note: Due to increasing amounts of SPAM sent to this account, please include "QOW" in the subject line when sending me email.

I look forward to reading what you have to say.

Health Community Coordinator
Access Excellence @ the National Health Museum

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