Nagging via text messages to help teens remember meds

If the simple reminders work for asthma, they may for other diseases, too.

"We have the science" backing treatments, Britto notes. "We just can't figure out how to get the right drugs into the right kids' bodies."

But remembering medication doses is only one part of a very complex problem. First, families must understand the importance of following treatment even when children feel fine. Then, parent-adolescent relationships play a huge role.

"Kids are thinking short-term and not long-term complications. If they're feeling better for the moment, there's a tendency to keep testing the limit," says Drotar.

He tracked teens whose leukemia was in remission, and found a shocking 30 percent had no evidence in their blood of the follow-up medicines designed to help keep them in remission.

Now Drotar's team is testing problem-solving techniques with those leukemia survivors, bringing in parents and teens to discuss treatment barriers and brainstorm solutions without nagging or teen-parent head-butting.

Peer pressure is another approach, talks from older teens who can empathize with the rigors of dialysis, for example, or who tell how they got sick from skipping treatment.

And in an NIH-funded study, researchers in Cincinnati, the University of Miami and the Nemours Clinic in Wilmington, Del., are tracking 9- to 11-year-olds and their families for three years, to pinpoint what predicts a drop-off in control of Type 1 diabetes during adolescence.

Not surprisingly, Drotar says, kids with stable families and positive parent relationships fare better.

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