378 - Sexually Transmitted Infections and Treatment Adherence among Adolescents in the Emergency Department: A Mobile Health Pilot Intervention

Poster Number: 378
Publication Number: 378.312

Dalena T. Nguyen, Childrens National Hospital, Washington, DC, United States; Meleah Boyle, Children's National Health System, Washington, DC, United States; Gia M. Badolato, Children's National Health System, Washington, DC, United States; Monika Goyal, Children's National Medical Center, Washington, DC, United States

Background: Adolescents account for nearly 50% of all newly diagnosed sexually transmitted infections (STI) annually and often receive sexual and reproductive health services in the emergency department (ED). However, when adolescents are prescribed outpatient treatment for STIs in the ED, less than 60% of prescriptions are filled.

Objective: To evaluate the impact of a mobile health (mHealth)/text messaging (TM) intervention on prescription fill rates and treatment adherence following STI diagnosis in the ED.

Design/Methods: From June 1 to December 15, 2021, patients 15-21 years were contacted for enrollment if they were tested for gonorrhea/chlamydia in the ED, prescribed outpatient STI treatment, and had a cell phone with TM capabilities. Enrolled patients received daily TM reminders to fill their prescription and barrier support for up to 7 days. Daily medication reminder TMs were sent once the prescription was reported to be filled. A survey was conducted via text or phone after completion of treatment. Primary outcomes were prescription filling and self-reported STI treatment adherence, and the secondary outcome was attitudes toward the TMs. Prescription filling data were abstracted from SureScripts, an informatics network that collects data about prescription filling from participating pharmacies. Descriptive statistics were used to summarize the data.

Results: A total of 137 patients were eligible to participate in the study. Of those, 62 (45.3%) were enrolled [30 (48.4%) completed the mHealth intervention, 8 (12.9%) opted out, 16 (25.8%) were lost to follow-up, and 8 (12.9%) are currently active as this is an ongoing study]. The mean age of enrolled participants was 18.0 years, and the majority were female (72.6%), NH-Black (87.1%) and had public insurance (68.9%) (Table 1). Almost all enrolled participants 51 (82.3%) filled their prescription and 26 (86.7%) of those who completed the study reported finishing their medication. Nearly all participants found the texts to be helpful reminders to fill their prescriptions (96.7%) and to take their medications (100%).Conclusion(s): mHealth can be an effective tool to address treatment adherence in adolescent ED patients, an at-risk population who may otherwise be difficult to reach. This intervention may increase treatment adherence which may help reduce the spread of STIs – a key for the broader management of public health.
Table 1. Participant Demographics and Treatment Adherence