Examining How SMS Text Messages Influence Physician and Patient Communication

Researchers in healthcare management has continually investigated new methods to improve the delivery of healthcare services when managing a chronic illness. When a patient is diagnosed with asthma during childhood, doctors have limited contact with their patients between visits. Fortunately, research has revealed that using SMS messages, or text messages, to communicate with patients about their condition between visits has been shown to be beneficial to the patient’s health and treatment. Therefore, SMS messages can assist nurses in health promotion as well as help communication between patients, nurses, and doctors, as they increase knowledge about treatment and symptoms and improve the quality of life for patients.

Several studies investigating how to improve communication between physicians and patients have utilized the Health Belief Model as the framework for the studies. The Health Belief Model is based on the principles that underlie cognitive theories, which are often utilized by psychologists. Cognitive theories hold that one must change their beliefs in order to change their behavior. As a result, cognitive theories have been the basis of theoretical constructs utilized in the healthcare field.

The Health Belief Model is a helpful tool that enables researchers to understand how individuals manage their illness. The Health Belief Model “explains change and maintenance of health-related behaviors and guides the framework of health behavior interventions” (Yun et al., 2012, p. 621). Based on cognitive principles, the model seeks to predict and explain changes in behavior. Yun and Arriaga (2013) explained that the model “predicts positive health-related behavior in terms of the psychological and experimental factors that lead to positive behavior change.” As a result, the Health Belief Model was the theoretical basis for two studies that were conducted by Yun and associates.

In 2012, Yun et al. (2012) created a study based on the Health Belief Model to investigate how to improve communication between physicians and asthma patients. Since the participants in the study were children, the researchers decided to investigate how SMS messages, or text messages, could affect communication and the maintenance of their health condition. Yun et al. (2012) explained that “we chose SMS on the pediatric patient’s mobile phone because of the high adoption rates within the teen/youth population” (p. 622). Therefore, the researchers designed a system that utilized text messages to assess the subject’s knowledge and status of their condition. Furthermore, the system allowed physicians to monitor the status of the patient and their messages (Yun et al., 2012), which helped to increase communication between the physician and the patient.

This study was conducted at a doctor’s office which specialized in the treatment of pediatric asthma. Thirty children, ages 10 and older, where assigned to three different groups which consisted of the “control group that received no text messages from the physician’s office, the Query group, where they were asked to respond to questions about their asthma symptoms, and the Query & Knowledge group, where they were queried about their asthma management status and given information to improve their asthma knowledge” (Yun et al., 2012, p. 625). The participants were given the Pediatric Asthma Caregiver Quality of Life Questionnaire (PACQLQ), the Pediatric Asthma Quality of Life Questionnaire (PAQLQ), an asthma knowledge test, and a pulmonary test before and after the study (Yun et al., 2012), which lasted about four months.

The results of the study were two-fold. This study determined that the “simple act of communicating knowledge and symptom awareness information via SMS leads to improved pulmonary function for pediatric patients” (Yun et al., 2012, p. 621). These findings prove that SMS messages increase knowledge about treatment and symptoms and that communication is essential for behavior change in patients. Furthermore, the researchers determined that “physicians utilized the data sent from the SMS system to monitor asthma management statuses” (Yun et al., 2012, p. 621). Nonetheless, this result shows that SMS messages provide patient information for physicians between visits and improves communication between physicians and their patients.

In addition, in 2013, Yun and Arriaga decided to follow-up the study by Yun et al. (2012), and another experiment was created based on the Health Belief Model. In this study, researchers sought to confirm the findings that SMS messages were effective at increasing a patient’s knowledge about their symptoms while improving communication between patients and physicians. Researchers recruited 30 pediatric patients (10-16 years old) who were being treated for asthma and placed them into three groups: a control group where patients received no text messages, a group where patients received a text message that measured their symptom awareness on alternate days, and a third group which assessed a patient’s symptom awareness and knowledge on their condition every day (Yun & Arriaga, 2013). This study lasted for 3.5 months, and patients and their parents were interviewed at the end of the study (Yun & Arriaga, 2013). Furthermore, text messages were received and assessed by doctors using the dashboard that Yun and colleagues designed for their first study on this topic.

The results of this study confirmed that SMS messages help patients change the way that they manage their disease, as the messages increased a patient’s knowledge about their symptoms and their condition. Furthermore, the messages helped to improve the quality of life of patients. These findings were based on the data which revealed that after “2095 queries were sent to 30 participants, patients in the groups which received a text message that measured their symptom awareness and those in the group which assessed a patient’s symptom awareness and knowledge on their condition showed improved lung function and quality of life over those participants who did not receive any text messages” (Yun & Arriaga, 2013). Finally, the study confirmed that SMS messages allow physicians to increase their communication with patients while monitoring their condition.

The study conducted by Yun & Arriaga (2013) utilized thematic analysis to analyze the data collected by the participants when interviewed at the end of the study. The thematic analysis allowed the researchers to “identify emerging themes based on the data in the interviews” (Yun & Arriaga, 2013). The themes that emerged by the analysis included “change in awareness, change in knowledge, compliance to the medication regime, and change in communication” (Yun & Arriaga, 2013). In turn, utilizing thematic analysis helped the researchers to understand how the participants in the study managed their asthma.

The findings in these two studies confirm that communication can be increased between physicians and patients when SMS text messages are sent that measure knowledge about their disease and the frequency of their symptoms. SMS text messages can also be applied to the use of the health care delivery model. Although the studies solely examined the efficiency of this communication tool in asthma patients, the system may also be useful when treating other diseases. For instance, the SMS dashboard can be utilized by doctors when treating patients who are suffering from diabetes since diabetes is a condition that involves a high level of maintenance. Moreover, SMS messages may improve the quality of life for cancer patients since symptoms must be routinely measured and treatment depends on the presence of symptoms and the state of health of the patient.

To conclude, SMS messages helps communication between patients and doctors, as they increase knowledge about treatment and symptoms and improve the quality of life for patients. When text messages are sent using a dashboard system, it allows patients to be informed about their disease and symptoms while enabling physicians to better monitor their treatment. In all, although the findings in these two studies were based on the data collected from asthma patients, the results can be applicable to treating other chronic illnesses, such as diabetes and cancer.