Texting to Save Children's Hearts & Lives

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The Pediatric Heart Transplant Program at NewYork-Presbyterian/Morgan Stanley Children’s Hospital is partnering with CareSpeak Communications to bring mHealth (mobile health) to its teenage heart transplant patients and their families. The CareSpeak system uses 2-way text messaging to ensure patients take their medications on time and as prescribed, significantly decreasing the likelihood of organ rejection due to medication non-adherence. The system's efficacy was demonstrated in research published in the November 2009 issues of Pediatrics.

The outlook for long-term survival in non-compliant patients can be as low as 30 percent, compared to 90 percent survival in compliant pediatric heart transplant recipients.

The Pediatric Heart Transplant Program at NewYork-Presbyterian/Morgan Stanley Children’s Hospital is working with CareSpeak Communications to bring mHealth (mobile health) to its teenage heart transplant patients and their families. The CareSpeak system uses 2-way text messaging to ensure patients take their medications on time and as prescribed, significantly decreasing the likelihood of organ rejection due to medication non-adherence.

“Despite extensive educational programs for families and pediatric heart transplant recipients, significant medication noncompliance still occurs with alarming frequency, particularly with adolescents, which can prove deadly,” said Dr. Linda Addonizio, the Director of the Program for Pediatric Cardiomyopathy Heart Failure and Transplantation at NewYork-Presbyterian/Morgan Stanley Children’s Hospital. ”The outlook for long-term survival in non-compliant patients can be as low as 30 percent, compared to 90 percent survival in compliant pediatric heart transplant recipients.”

Nearly 30,000 organ transplants were performed in the USA in 2009 , and more than 100,000 people are still waiting to receive a life-saving organ transplant. Being lucky enough to receive an organ is only half the battle. Following a transplant, organ recipients have to follow a very strict medication regimen to prevent the body from rejecting the “foreign” organ for the rest of their lives. To prevent organ rejection, patients must take drugs known as immunosuppressants every day, multiple times per day, for as long as they live. Failing to do so can result in hospitalization, the need for a re-transplant, and unfortunately even death.

The problem of medication non-adherence is especially challenging with the teen population. According to the journal Pediatric Transplantation (February 14, 2008), non-adherence is the most common cause of organ rejection in long-term transplant patients, and adolescents are in the most high-risk category. Studies have shown that more than half of all teenage liver transplant recipients are non-adherent, and they are four times more likely than adult patients to take their medications at the wrong time or to forget to take them at all.

CareSpeak’s system uses everyday technology and behavior to help solve this significant problem – the cell phone and text messaging. Not only is the system easy to use and accessible anytime, anywhere, but it is also the perfect fit for teenagers who are notorious text messagers. It doesn’t require learning a new system or purchasing and carrying another device.

When it’s time for the patients to take their medications, the patient or their caregivers receives a text alert “Joe it’s 8:15am, time to take 1 pill Prograf 1mg. Press REPLY, enter CARE 1 and press SEND”.. In the case of older children who have their own cell phone, the text message is sent to them directly. If the patient doesn’t confirm medication intake within a pre-determined amount of time (e.g. 30 minutes), a follow up escalation text alert is sent to as many as two caregivers, alerting them that the patient didn’t report taking their medication. The caregiver message includes the patient’s cell phone number allowing for immediate response. Clinicians can access an on-line dashboard at any time to view the patients’ self-reported compliance, frequency of escalation alerts to caregivers, and can also receive weekly e-mail reports.

The efficacy of the system was demonstrated in research published in the November 2009 issues of Pediatrics (http://pediatrics.aappublications.org/cgi/content/abstract/124/5/e844), and it was subsequently written about in The New York Times (http://www.nytimes.com/2009/11/05/health/05chen.html). The study found that as a result of receiving regular text alerts through the CareSpeak system, patients were more likely to have higher adherence rates. The number of rejections dramatically decreased from 12 episodes the previous year to only two during the study.

“Before this program, we had only the power of people trying to educate the children and their families about the deadly nature of noncompliance,” said Dr. Addonizio. “Now we have the ability to give these adolescents a safety net to help them become responsible.”

“We are very proud to get the opportunity to work with NewYork-Presbyterian/Morgan Stanley Children’s Hospital and its staff, and we feel a tremendous sense of satisfaction and gratitude to be able to contribute towards the quality of life of these children and their families,” said Serge Loncar, CEO of CareSpeak Communications.

According to a report published by the Taskforce for Noncompliance in 1994, the direct and indirect impact of medication non-compliance is over $100 billion per year in the U.S. alone.

“With the aging population trend and earlier onset of illnesses such as Diabetes, this problem is only going to get bigger,” added Loncar. “At CareSpeak, we believe that a simple and reliable technology such as the CareSpeak system can have a huge public health and economic impact.” CareSpeak Communications continuously upgrades its system design by collaborating with major clinical centers and pharmaceutical companies, in order to include features that will further help increase adherence across all disease verticals such as Diabetes, Behavioral Health, Cardiac health, Cystic Fibrosis, HIV and others.

For additional information, please contact:

Serge Loncar, CareSpeak Communications, Telephone: +1 (732) 763-9436, Fax +1 (732) 432-9513, E-mail: sloncar(at)carespeak(dot)com, web: http://www.carespeak.com

CareSpeak Communications provides mobile communications technology solutions to health care professionals, patients, and caregivers for better medication compliance resulting in more successful treatment outcome for the patient, increased profit and cost savings for insurers and employers respectively, and increased revenues for pharmaceutical companies, retail pharmacies & PBMs. CareSpeak Communications is a New Jersey-based, privately held company.

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