Letters

Mobile phone text messaging can help young people manage asthma

EDITORThe main reason why asthma is suboptimally controlled in many young people is that the medicine (inhaled drugs) and the message (education) do not reach their intended targetthe lung and the brain. Doctors try to make young people comply with treatment while young people try to make the disease comply with their lifestyle. ^{1 2}

We set up a mobile phone text message service consisting of daily reminders to use an inhaler, health education tips, and safety messages. We streamed these into a supply of lifestyle related text messages about sport, celebrity gossip, and horoscopes; they were all written in contemporary text jargon and sent by a "virtual friend with asthma" called Max. Thirty two young people with asthma from Tayside, Scotland, were recruited through local radio to take part in a study to assess the safety, reliability, acceptability, and effectiveness of the service. The study was approved by an ethics committee.

We ran focus groups before and after the study and tracked all text messages sent and received by our participants (age range 10 to 46, median 16) over one month. There were no adverse safety events, and the service was technically reliable.

The 30 participants who completed the service thought that the tone and style of the text messages and the medium were credible. They commended us for basing the service around novelty lifestyle text messages with the optional provision of medical facts and reminders available on request. Participants seemed to develop a rapport with their virtual friend with asthma and frequently sent text messages back to Max. Compliance with using an inhaler may have favourably changed in response to the service (box).

Some text message dialogues "Bonjour, c'est Max. Hav U taken Ur inhaler yet?" "Yea, I'm off to take it now" (Kim) "Buenas noches. Max here. Forgotten something 2day?" "Beat U 2 it. Just tkn it!" (Laura) "Yo dude, its Max reminding U2 takeur inhaler" "Yep dis mornin" (Alex) Improved compliance "I used to forget [my inhaler] two or three times each week . . . I haven't missed once this month" (Kevin)

Text messages that are reminders about treatment and useful tips on education may be a medium to allow people with chronic health problems to make their disease comply with their lifestyle and not the other way around.

Ron Neville, general practitioner. 
Westgate Health Centre, Dundee DD2 4AD r.g.neville{at}dundee.ac.uk

Alexandra Greene, lecturer in social anthropology. 
Department of Social Anthropology, University of St Andrews, St Andrews, Fife KY16 9AL

John McLeod, professor of counselling. 
Department of Social and Health Sciences, University of Abertay, Dundee DD1 1HG

Andrew Tracy, project manager. 
John Surie, director. 
Wonderworks (Communication Consultancy), London NW1 8JD