Nagging via text messages to help teens remember meds

Cincinnati doctors are experimenting with texting to tackle a big problem: Tweens and teens too often do a lousy job of controlling chronic illnesses like asthma, diabetes or kidney disease.

It's a problem long recognized in adults, particularly for illnesses that can simmer without obvious symptoms until it's too late. But only now are doctors realizing how tricky a time adolescence is for skipping meds, too.

Of necessity, parents start turning over more health responsibilities to their children at this age. It's also an age of angst, sometimes rebellion, and when youths may most hate feeling different from their friends because of medication, special diets or other therapy.

"It's a time of so much change in these kids' lives," says Dr. Marva Moxey-Mims, a specialist in pediatric kidney disease at the National Institutes of Health. "It's very difficult when you've got a life-threatening illness to say, 'Let them make their mistakes.'"

There are few good statistics on how many chronically ill kids don't adhere to therapy. But what little data exists is alarming enough that the NIH's National Institute of Diabetes and Digestive and Kidney Diseases will bring specialists together in September to debate next steps:

_Some studies suggest only half of adolescents, on average, properly follow treatment steps, says Dr. Dennis Drotar of Cincinnati Children's Hospital. The more medications required or the more troublesome the side effects -even, for appearance-conscious teens, such things as weight gain from steroid medications -the worse kids adhere.

_Asthma's record is particularly bad, with research suggesting as few as 30 percent of teenagers correctly take medication to prevent asthma attacks.

_Among kidney transplant recipients, adolescents have the worst long-term outcomes of any age group, says Moxey-Mims.

Even when parents try to keep close tabs, "kids are cunning," Drotar notes. "Parents are in a bind because there's pushback."