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Doctors Experiment with New Ways to Help Teens Follow Medical Advice

Teenagers are notoriously lax about following doctor's orders. Only about 30% of asthmatic adolescents correctly use their medications, for example. Even teens with life-threatening conditions such as cancer and those with kidney transplants have the worst records of compliance with following procedures and taking medications. One study of adolescents with leukemia found that 30% had not used medications designed to keep them in remission.

Diabetic teens and teens with bipolar disorder often go through periods in which they do not follow any doctors' orders. Some refuse to acknowledge they need medical intervention because that makes them "different" from their peers at a time in their lives when peer acceptance is paramount. In addition, many teens will not take pills that have side effects such as drowsiness or weight gain.

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

However, researchers at the Cincinnati Children's Hospital are now performing a pilot study to help teens become more compliant with medical follow-ups. Volunteers send text messages to teens on their cell phones to remind them to take medications. Preliminary results are promising, and the full study should be complete within a year. Another approach the Cincinnati team is trying is to have older teens that have been through the same disease procedures talk to younger ones about the importance of compliance.

Dr. Maria Britto, a doctor who specializes in children's asthma at the Cincinnati Hospital, said that some of this is frustrating. "We have the science backing treatments," she said. "We just can't figure out how to get the right drugs into the right kids' bodies."

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