Funny Business with Jane Wells

Wait, Texting Can Save Your Life?

I got an email which merits a Funny Business blog based solely on its title: "Text messages may increase use of sunscreen."


At first blush, that title is one of the greatest non sequiturs I've ever seen, and it came from JAMA of all places. What would be next? "Scratching will improve savings." "Cursing lowers your carbon footprint." "The impact of buying wholesale on drunk driving."


Turns out it's not quite so crazy. Instead, the JAMA report points out one obvious positive use for texting—reminders.

In the November issue of Archives of Dermatology (I'm assuming you subscribe, who doesn't?), doctors at UC Davis experimented with a low-cost way to convince people to use sunscreen regularly.

"Skin cancer accounts for one in three cancer cases worldwide and more than 1 million new cases are diagnosed in the United States each year," the study declares. So the doctors took 70 people and divided them into two groups. One group received a text message every day giving them the weather forecast and reminding them to put on sunscreen. The other group got nothing. "Adherence was assessed through electronic adherence monitors adapted to participants' sunscreen tubes that would send electronic messages to a central station every time the cap of a tube was removed." That's some technology! The only way to cheat was to remove the cap every day but not actually put on sunscreen, which seems like a lot of work.

After 42 days, the group which had received the daily text reminders put on sunscreen 24 days, so around 56 percent of the time. In contrast, the group which received no messages, BUT STILL KNEW IT WAS BEING MONITORED, put on sunscreen only 13 days, or about 30 percent of the time. I'm kind of surprised the group getting the messages only broke the 50 percent mark. That's not very often, especially for people who knew they were part of a study. Of course, maybe they had goopy smelly sunscreen. I hate that stuff. There's the industry's number one problem. Non-goopy, non-greasy, non-smelly sunscreen costs too much.

The dermatologists seemed surprised at how little compliance there was among patients, especially those in the group not getting text reminders, people who still knew they were being monitored. “While we recognize that patients may not be using their sunscreen well, much dogma in dermatology is based on the assumption that patients are following medical treatment routines as directed," write Bridgit Nolan and Dr. Steven Feldman of Wake Forest University School of Medicine. "The assumption that adherence is invariant is grossly inaccurate, such that many conclusions about the relationship between disease and treatment may be erroneous.” That's fancy doctor-talk for saying physicians are amazed we ignore their advice so much, and they need to come up with new ways to get us to comply. Texting is cheap, easy, and at least somewhat effective.

But if text reminders help people put on sunscreen more often, and, therefore, potentially save their lives, why stop at sunscreen? Why not send reminders to patients on statins to take their drugs? Or transplant patients? This is an idea Dr. Patrick Soon-Shiong mentioned to me last month.

Meantime, I need to put on some sunscreen…

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