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The use of text messaging to improve asthma control a study of short message service (SMS)
LATHY PRABHAKARAN 1, JANE C 1,CHUA K C2, WONG W M3, ABISHEGANANDED J 4,
Department of Nursing 1, Clinical Research Unit 2, National Health Care Group3, Respiratory Medicine 4, Tan
Tock Seng Hospital, Singapore
AIMS OF STUDY
To evaluate the feasibility of using SMS for symptoms
monitoring through mobile phones by patients admitted
for asthma
RESULTS
Figure 1: Asthma cases screen during the recruitment Aug 07-June 08
Asthma cases screen from Aug 07 to June 08
N = 497
BACKGROUND
Patients with chronic disease are being followed up
regularly in hospital clinics. This had added on to the
burden of hospitals focusing on treating acute and
complicated patients.
Excluded
N = 377
Control group
N = 60
Intervention Group
N = 6o
Figure 2: Frequency distribution of reason for exclusion
140
Frequency
Stable chronic disease patients can safely and rightfully
be monitored at home, returning to hospital for
consultation only when there are changes in his or her
conditions.
120
100
80
60
40
20
0
The use of technologies to improve of patient behaviour
is documented within several area e.g. vaccination1 oral
contraceptives2 and use of prescribed medication3 .
Home monitoring was used to collect data of patients
for better clinical management and to avoid unnecessary
visits to expensive tertiary care institutions, while
allowing patients to be safely monitored
Below 21 years Significant comorbidity
Don't have HP Don't know how
to SMS
Non-English
speaking
Unwilling to
participate
Intermitten
asthma
Table 1: Analysis of demographic for exclusion from the study
Demographic characteristics
P value
Sex
NS
Age
P <0.001
Race
Chinese
P=0.001
Malay
P<0.001
Indian
P = 0.6
CONCLUSION
Coupled with a highly educated population and good
accessibility of technologies in Singapore, it is imminent
for NHG to explore engaging patients in Home
Monitoring.
 We found reliable difference in patient
characteristics to suggest that the SMS service may
not be suitable for certain types of patients.
In this pilot service patients receive SMS on their
mobile phone
 Implementation efforts should be aware that other
methods of outreach may be necessary for these
patient subgroups.
METHODOLOGY
The recruitment started in August 2007.
ACKNOWLEDGEMENT
All consecutive patients admitted with the diagnosis
of asthma were screen using inclusion and exclusion
criteria.
• The authors would like to thank Ms Syahidah Salleh
2nd year nursing student from Nee Ann Poly for her
assistance in data entry and management.
Patients were randomized into 60 in the control and
60 in the intervention group.
Patients in the intervention group received SMS
messaging following a structured workflow whereas
patients in the control group had no SMS support.
 REFERENCES
Vilella et al. The role of mobile phones in improving vaccination rates
in travelers. Prev.Med.2004 Apr;38(4):503-509.
1. Fox et al. Feasibility study of the use of daily electronic mail
reminder to improve oral contraceptive
compliance.Contraception.2008 Nov; 68(5):365-371.
2. Hagstrom et al. What happened to the prescriptions? A single short
standardized telephone call may increase compliance. Fam
Pract.2004 Feb;21(1):46-50.