Interactive Mobile Health Information to Enhance Patient Care at a Cystic Fibrosis Center
Interactive Mobile Health Information to Enhance Patient Care at a Cystic Fibrosis Center
Real-world adherence to inhaled and oral therapies for cystic fibrosis (CF) patients remains
 discouragingly low, ranging between 31-53% for inhaled antibiotics and 41-72% for hypertonic
 saline. Programs to enhance adherence, including comprehensive behavioral interventions with
 adolescents, have met with mixed success. Advances in therapy, treatment delivery systems,
 and data capture technology offer the potential for enhancing adherence by providing
 immediate and more frequent feedback to the patient regarding his or her fidelity to the
 prescribed treatment regimen. The investigators propose to evaluate a systematic yet
 technically simple approach to linking treatment and feedback components to enhance adherence
 in a real-work CF clinic setting that treats a significant minority patient population.

 This is the first trial assessing the impact of a collaborative active intervention program
 of a multi disciplinary team in improving adherence to specific chronic medications and
 improving clinical outcomes in CF patients. The PI has implemented the texting service
 (Caremessage.org) with COPD and diabetes patients. The content will be modified to provide
 both English and Spanish language content relevant to these participants and their standard
 treatment protocols.
This study will evaluate the effectiveness of an interactive mobile health information
 service in supporting clinic staff (i.e., nurse practitioners, case managers and care
 coordinators) at a Cystic Fibrosis Center clinic to connect with patients and create
 conversations around behavior-centered goals. The interactive mobile health information
 service has been designed to supplement the standard of care by supporting
 patient-empowerment strategies through:

 -  educating participants,

 -  encouraging behavior change, and

 -  promoting adherence with their treatment protocols.

 The project will adapt the iCAN program content as an educational tool to be incorporated in
 the educational material. iCAN is an electronic platform aimed to provide an engaging
 environment for diabetic outpatients to self-manage, gain control over their health, and
 ultimately adhere to their medical appointments and regimen. Similar to diabetes, CF is an
 all-encompassing chronic disease that requires coordinated efforts among patients,
 caregivers, and health-care providers across treatment adherence, nutrition, lifestyle
 choices, and social support systems. Central to the mobile health information service is the
 interactive and personalized text-based message system that delivers actionable and tailored
 health content to participants: office visit appointment reminders; medication adherence
 reminders; and general health education messages. While a number of technically sophisticated
 applications exist, our approach will involve a less sophisticated and complex approach. Our
 primary objective is to get the information to the patients, some of whom are members of
 lower income minority communities. If "simple" interventions prove effective, then the
 groundwork will have been laid for considering more tailored albeit complex systems.
Inclusion Criteria:

 -  Patients with diagnosis of Cystic fibrosis at all ages;

 -  Their associated CF Center professionals;

 -  Their associated family;

 -  CF patients that should be treated with one or more of these chronic medications: Tobi
 (Tobramycin), (Colistin), Pulmozyme (Dornase Alpha), Hypertonic Saline (HS), Creon
 (pancreatic enzymes), AquaADEKs (Multivitamin);

 -  Patients willing to participate in a trial;

 -  Presence of a parent/guardian capable of providing informed consent; and

 -  Patients attending CF clinic at least once every 12 months.

 Exclusion Criteria:

 -  Absence of a parent/guardian or unwillingness to provide permission;

 -  Potential participant declines to provide assent; and

 -  Transplant patients.