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Texting fails to boost flu shots in pregnant women

By Trevor Stokes

NEW YORK (Reuters Health) - Text message reminders don't increase flu vaccinations in pregnant women, according to a small pilot study.

"Text messaging may be effective in some contexts and not in others," lead study author Dr. Michelle Moniz, of the University of Pittsburgh School of Medicine, told Reuters Health.

Between 2010 and 2011, researchers sent 12 weekly text messages to 158 pregnant women who were mostly poor, black, uninsured and had previously declined to receive a flu shot.

All expectant mothers received text reminders to take prenatal vitamins and to eat nutritious foods, but half of the women received messages to get vaccinated. Even with the additional encouragement, only around 30 percent in either group received flu shots in the study that appeared in the journal Obstetrics & Gynecology.

The U.S. Centers for Disease Control recommends all pregnant women get flu shots.

Though vaccination rates didn't change, most women (90 percent) said they enjoyed receiving the text messages and the majority (70 percent) said prenatal care was more satisfying with text message reminders.

Texting is moving past teenaged LOLs and into the doctor's office as physicians worldwide figure out how to use the 160-character messages as an inexpensive, private and convenient mode of communication to help patients.

Studies have already shown that text reminders can help patients quit smoking, manage chronic illnesses like diabetes and follow through on some vaccinations.

However, an analysis of 42 clinical studies of text messages showed in January that text reminders only modestly increased patient attendance to their doctor's appointments.

"We really don't know the best way to harness the technology in order to communicate from provider to patient," said Carolyn Rose Ahlers-Schmidt, research associate professor at the University of Kansas School of Medicine - Wichita, who in her own work has found text reminders to new mothers don't increase vaccination rates in their newborns.

Instead of focusing on texting, clinics require a broader communication system so if a patient's cell phone is disconnected, an email is sent or if a text bounces back, an automated voice message is sent, said Ahlers-Schmidt, who was not involved in the current study

Texting may not have changed flu shot rates, Moniz said, because the pregnant study participants were particularly wary of side effects, didn't like shots, or had had a bad experience with the flu vaccine.

Successful texting efforts focused on participants who were willing to get vaccinated in the first place and needed booster shot reminders, Moniz said, unlike the unwilling pregnant women.

"This challenges us to be more creative in the way we do text messaging," said Keith Petrie, a professor of psychological medicine at the University of Auckland in New Zealand, who has found in his own research that text messages tailored to individual asthma patients can help increase medicine adherence.

"There's great potential for the technology to be used just as an alarm, which in the end can be quite annoying," Petrie, who was not involved in the current work, told Reuters Health.

SOURCE: bit.ly/16f6TzA Obstetrics & Gynecology, online March 7, 2013.

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