ACCEPTABILITY OF TEXT MESSAGING AS A TOOL TO COMMUNICATE WITH CHRONIC LIVER DISEASE PATIENTS

Monday, October 24, 2011
Grand Ballroom AB (Hyatt Regency Chicago)
Poster Board # 19
(ESP) Applied Health Economics, Services, and Policy Research

Candidate for the Lee B. Lusted Student Prize Competition


Ayan Rage, MD1, Tuyyab Hassan, MD, MRCP1, Ayesha Kanwal, MD1, Kevin Mullen, MD1 and Adam T. Perzynski, PhD2, (1)Metrohealth Medical Center, Cleveland, OH, (2)Case Western Reserve University at MetroHealth, Cleveland, OH
Title: Acceptability of Text Messaging as a Tool to communicate with Chronic Liver Disease Patients

Purpose: This study evaluated the usefulness of text messaging (TM) for reminders, cancelling appointments and receipt of laboratory results in patients being evaluated in the liver clinic in an urban safety net teaching hospital. No prior study has examined the feasibility and acceptability of TM as a form of communication with specialty care patients in urban safety-net care settings.  TM may be a more acceptable to patients who feel stigmatized by chronic Hepatitis C (HCV).  Additional means of communicating with patients who are difficult to get hold off could increase show rates and improve treatment adherence.

Methods: A total of 100 patients completed a cross-sectional paper and pencil survey in an outpatient GI clinic over 4 weeks. Data collected included demographics, education level, baseline use of mobile phone and texting, and other communication modalities (such as home phone, email, post card etc.). 79% of subjects were between the ages 36 and 65.  Subjects were 54% male, 41% Non-Hispanic White, 47% Black, 8% Hispanic, and 2% Asian. 

Results: 89% reported having a cell phone. From this group 80% stated that they had ever used TM. 66% reported missing medical appointments at least once a year and forgetfulness was the most commonly cited reason (47%). Among subjects with a cell phone 52% used TM at least monthly. The majority (61%) claimed that TM reminders would be at least a little helpful. Greater than one-third of the sample felt that TM would be very helpful for appointment reminders, lab results or cancelling appointments. Frequency of TM was associated with finding TM as helpful for reminders (r=.56,p<.001) getting lab results (r=.44,p<.001) and cancelling appointments (r=.62,p<.001). Age, gender, and racial background were not associated with frequency of TM or preferences for TM. 

Conclusions: TM has high acceptability among urban safety-net liver clinic patients. As TM usage grows, more and more patients will be interested in communicating with health providers via TM. Given the overall acceptability of TM reminders in this survey, TM reminders could be useful for promoting strict adherence among patients prescribed one of the new oral (three times per day) HCV treatments.