Date of Publication
Dr. Margaret Aitken; Lisa Bolduc-Bissell, RN, CDE
Purpose: Pediatric patients who have complex medical needs require guidance and education through a transition process from their pediatric to adult specialty provider. Without support throughout this process, youth are at risk for problems with self-management and medication adherence, have higher emergency room use and hospital admissions, and have a higher cost of care. Utilizing a texting platform is a method that has been replicated in research of adolescents and shown to be an effective way to provide education. Nurses and nurse practitioners can help facilitate this process by leveraging established relationships with patients and families.
Methods: A 16-week texting program was conducted with 14 pediatric specialty patients aged 13-21. Nurses and physicians identified and recruited patients at office visits, via telephone, or via the online portal. The platform sent out one text message per week to adolescents to ask yes or no questions about different aspects of their healthcare according to Got Transition guidelines. Messages asked about understanding of their chronic condition and medical history, ordering prescriptions, contacting the provider’s office, and preparing for appointments. The chatbot then replied with links depending on how the user interacted.
Results: Mean response rate was 79.5%, near projected rate of 80% and compared to 97% engagement during the pilot study.
Conclusions: This project identified a method that can be implemented in the clinical setting that supports adolescents throughout the transition process from pediatric to adult specialty. Next steps include program sustainability, quantifying healthcare cost savings, engaging stakeholders in long term transition planning, and integration into clinical workflow via the electronic health record.
Pickering, Rebecca, "Txt4toc: Improving the transition process for youth with special health needs" (2022). College of Nursing and Health Sciences Doctor of Nursing Practice (DNP) Project Publications. 89.