Category: Health Psychology / Behavioral Medicine - Child

Symposium

Behavioral Mobile Health Intervention: Adherence and Disease Knowledge Among Youth With Sickle Cell Disease

Saturday, November 18
1:45 PM - 3:15 PM
Location: Indigo Ballroom B, Level 2, Indigo Level

Keywords: Behavioral Medicine | Medication | Psychoeducation
Presentation Type: Symposium

Sickle cell disease (SCD) requires complex health management to minimize complications and maximize health outcomes for youth. Adherence to daily treatment targets among youth with SCD typically ranges from poor to moderate, increasing risk for illness-related morbidities and poor health-related quality of life (HRQL). Increasingly, mobile health technologies are used to facilitate pediatric health behavior change. The current study examined the application of a mobile health intervention to improve health-related behavior and disease knowledge among youth with SCD. The feasibility of this intervention was previously described (Anderson et al., 2017). Thirty-two youth 8-18 years old prescribed hydroxyurea (HU) enrolled in a 90-day intensive training program (ITP). The ITP included three provider-led education modules, medication tracking via video “selfies,” and provider reinforcement through video messages in the app. Adherence was assessed via compliance tracking in the app, medication possession ratio (MPR) per pharmacy records, and medical record review.


All participants demonstrated increased MPR disease knowledge post-ITP. At follow-up, intervention completers had better SCD-related functioning, higher treatment functioning, and lower pain impact than non-completers. Non-adherent participants had lower SCD functioning and parent- and child-rated treatment functioning and greater pain impact compared to those rated as adherent. Caregivers of non-adherent patients also reported fewer emotional resources greater medical care burden and role function burden. These results suggest promise for a behavioral adherence intervention using mobile health technology. Long-term monitoring of patient and parent functioning may be helpful for targeting those at-risk for intervention failures. Indeed, mobile health interventions tailored to patient needs may require ongoing provider-patient-family collaboration to optimize efficacy over time.


 

Lindsay Anderson

Postdoctoral Fellow
Duke University

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