With one out of every four youth in the United States currently living with a chronic illness, it is critically important to empower youth to take ownersip of their own healthcare. Research suggests that a key component of a successful transition from pediatric care into adult-focused health care systems is proper management of treatment regimens [1]. Unfortunately, treatment adherence among adolescents with chronic illness is disappointingly low, with poor adherence found in 50-70% of all patients [2]. Reviews of adherence studies indicate the risk of treatment nonadherence declines with greater disease- and treatment-related knowledge and that providing a behavioral management component optimizes adherence [8-10]. The goal of this Phase II SBIR project is to continue the research and development of the Online Medical Monitoring System (OMMS), an integrated online and mobile technology infrastructure specifically designed to (a) enhance youths'disease- and treatment-related knowledge through interactive and game-based educational materials;(b) support adherence to the treatment regimen through customized task prompts via mobile and web-based delivery;and (c) promote patient-provider communication through real-world data collection and synchronized feedback loops. During Phase II, we will build on Phase I feedback to finalize the fully functioning product and conduct a field test examining the degree to which the OMMS enhances treatment adherence outcomes among adolescents with a variety of chronic illnesses. This Phase II project will accomplish three specific aims: 1) fully develop the OMMS product;2) conduct a field test of the benefits of the OMMS with adolescents with chronic illness;and 3) finalize the OMMS and ready for broad scale commercialization. To our knowledge, the OMMS will be the first technology product that integrates educational, adherence tracking, and patient-provider communication tools into one comprehensive, streamlined package. We expect the OMMS to effectively provide essential information and much needed support to youth with chronic illness to help them successfully negotiate their treatment regimen and transition into self-managed healthcare.
Medical non-adherence has been identified as a major public health problem among youth that imposes a considerable financial burden upon modern healthcare systems [3-7]. Because of the complexities in measuring adherence, no estimate can be generalized, but poor adherence is to be expected in 50-70% of all adolescent patients with chronic illness, irrespective of disease, prognosis, or setting [4, 6, 8-10]. This burden has been estimated to cost $100 billion each year in the United States [5], including 10% of hospital admissions [4, 6]. Adherence is also critical to the integrity of clinical research findings to preserve sufficient statistical power for analysis and to minimize the potential for obscured findings. Indeed, as clinician's increasingly rely on treatment protocols that are based on clinica trial evidence, it is critical to address adherence in the realm of research as well [11-16]. The proposed Online Medical Monitoring System (OMMS) would remove barriers to adherence monitoring and provide significant advantages in convenience and utility over existing clinical options.
