January 2010: Srdjan Loncar of CareSpeak Communications
Agency for Healthcare Research and Quality (part of US Department of Health & Human Services) profiles CareSpeak's technology in their Innovation Exchange web site. [more]

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December 2009: Srdjan Loncar of CareSpeak Communications Talks to mHealth Update
mHealth Update recently caught up with Srdjan ‘Serge’ Loncar, Founding President and CEO of CareSpeak Communications to discuss the company’s work and the mobile health industry as a whole. [more]

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November 12, 2009: November Spawns Wireless Health Momentum
A team at Mt. Sinai worked on a pilot program with with wireless health start-up CareSpeak that used text message reminders to increase the rate of adherence among young liver transplant patients to their medication regimen. [more]

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November 5, 2009: Mt. Sinai, CareSpeak Text Liver Transplant Patients
“If we can save one patient from needing another transplant, we’ve saved a life and at least a half-million dollars. The investment is relatively little and the benefit enormous.” Dr. Tamir Miloh, assistant professor of pediatrics and surgery at Mount Sinai Hospital in New York. The investment? Text message reminders for teenage liver transplant patients . [more]

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The New York Times published the article Texting as a Health Tool for Teenagers citing the Mt. Sinai clinical study and CareSpeak platform. [read full article]

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PEDIATRICS, the official journal of the American Academy of Pediatrics, published in the October 2009 issue a research paper entitled Improved Adherence and Outcomes for Pediatric Liver Transplant Recipients by Using Text Messaging. In this study Mt. Sinai Medical Center’s Pediatric Gastroenterology department conducted a year long study using CareSpeak’s MediM AS adherence and persistence system to reduce liver transplant rejections due to patients’ poor medication compliance. The publication of the positive research results in Pediatrics, a peer reviewed journal of the highest professional standards, is a further testament to the credibility and validity of the research results and effectiveness of CareSpeak’s MediM AS adherence and persistence system. Read Summary

Pediatrics has been continuously published by the American Academy of Pediatrics since January 1948. Pediatrics has the second highest impact factor (4.473, 2007 Thompson Journal Citation Reports) among all journals in the field of pediatrics. It is among the top 2% most-cited scientific and medical journals (38,973 total citations in 2007) and is the most-cited journal in the field of pediatrics. (Source: Wikipedia.org)
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FOR IMMEDIATE RELEASE

Contact: Serge Loncar, CareSpeak Communications, Telephone: +1 (732) 763-9436, Fax +1 (732) 432-9513, E-mail: sloncar@carespeak.com, www.CareSpeak.com

Text Messaging Medication Reminders Significantly Reduces Organ Rejection in Pediatric Liver Transplant Recipients.

Mt. Sinai Medical Center's Pediatric Gastroenterology Department published results from a promising yearlong study conducted with pediatric liver transplant patients using CareSpeak Communications' MediM AS medication reminder system to keep them taking critical medication on schedule. By sending text message reminders to 41 pediatric patients and/or their parents, only 2 patients experienced a rejection episode versus 12 patients prior to the use of the MediM AS system.

New York, NY - June 2, 2009 -- Mt. Sinai Medical Center's Pediatric Gastroenterology Department, under the leadership of Dr. Tamir Miloh, published results from a promising yearlong study conducted with pediatric liver transplant patients using CareSpeak Communications' MediM AS medication reminder system to keep them taking critical medication on schedule.
Successful treatment of patients after Orthotopic Liver Transplantation (OLT) requires regular intake of medication and non-adherence with medication has been reported in up to 40% of adolescent OLT recipients. Non-adherence can include not taking the medication at the prescribed frequency, dose or time and can be deliberate or unintentional. Non-adherence has been associated with severe morbidity: acute/chronic rejection, end stage liver disease, hospitalizations, rising costs, re-transplantation and even death. The most common reported reason for non-adherence in OLT recipients is forgetfulness.

Improving compliance with medication is essential to improving long-term outcomes in pediatric transplant recipients. Current methods of improving adherence for chronic health problems are mostly complex and not very effective. The aims of the study were to pilot test the effects of text messaging medication reminders on patient's adherence and outcome.
"This new technology may prove effective in the transition of responsibility from caregiver to child. These results should be of interest to health-care professionals and policy makers, as it may reduce the morbidity, mortality and the utilization of financial and human resources associated with liver transplantation. Text messaging is a behavioral support intervention that can be incorporated into routine clinic care, personalized and adapted to suit other chronic disease and age groups." said Dr. Miloh.

The study included 41 patients between the ages of 1 and 27 years old (median age 15) who were taking anywhere from 1 to 3 specific medications to suppress the immune system daily. The medication was either self-administered or by the parent/caregiver. Patients or their parents/caregivers received a text message when it was time for the patient to take their medication. In the case of older patients that possessed their own cell phone, the text messages were sent to the patient directly. If the patient didn't confirm via a return text message medication intake within a pre-determined amount of time (e.g. 30 minutes), a follow up message was sent to the parent/caregiver alerting them that patient potentially didn't take medication. The caregiver message included the patients' cell phone number allowing for immediate dialing.

After the 12-month period of the study, compared to the previous 12-month period prior to the study, this group of patients showed significant improvement in medication adherence (evident in stable, on target blood levels of the medication). This resulted in significantly lower number of organ rejection episodes in this group; 12 cases in the year before the study and only 2 during the study year. Organ rejection usually requires immediate hospitalization and treatment lasting on average anywhere from 6 to 10 days, or in extreme cases a re-transplant. In addition to the significantly negative impact on the patients overall health, it poses a significant cost to the hospital and health insurance provider.

"According to a report published by the Taskforce for Noncompliance in 1994, the direct and indirect impact of medication non-compliance is over 100 billion dollar per year in the US alone. With the aging population trend and earlier onset of illnesses such as Diabetes, this number is only going to get bigger. At CareSpeak, we believe that a simple and reliable technology such as the MediM AS system can have a huge public health and economic impact.", said Serge Loncar, founding President and CEO of CareSpeak Communications.

Loncar says that the CareSpeak platform is very flexible and scalable. The company plans to launch the DiabeText Juvenile Diabetes application in the coming weeks, and an application for monitoring large mental health patient populations in the 2nd half of the year.

For additional information please contact: Serge Loncar, CareSpeak Communications, Telephone: +1 (732) 763-9436, Fax +1 (732) 432-9513, web: http://www.carespeak.com

CareSpeak Communications provides mobile communications technology solutions to health care professionals, patients, and caregivers for better medication compliance resulting in more successful treatment outcome for the patient, increased profit and cost savings for insurers and employers respectively, and increased revenues for pharmaceutical companies, retail pharmacies & PBMs. CareSpeak Communications is a New Jersey based, privately held company.
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Public release date: 1-Jun-2009

Contact: Aimee Frank
newsroom@gastro.org
301-941-2620
American Gastroenterological Association

Liver disease: Better monitoring, better prognosis
Health outcomes explored at DDW 2009

CHICAGO, IL (June 1, 2009) – The latest research in liver disease being presented at Digestive Disease Week® 2009 (DDW®) has important implications for tracking disease development in patients and for current and future transplant recipients. Researchers are making great strides in diagnosing and treating liver disease.

"The research being presented during DDW shows how widespread our efforts are in understanding and treating liver disease," said Brent Tetri, MD, Saint Louis University. "These studies take us one step closer to better monitoring of liver disease, improving our ability to accurately determine prognosis, more appropriate organ allocation and lower rejection rates in liver transplantation."

DDW is the largest international gathering of physicians and researchers in the fields of gastroenterology, hepatology, endoscopy and gastrointestinal surgery.

Text Messaging Reduces Rejection in Pediatric Liver Transplant Recipients (Abstract #175)

Text messaging may improve compliance rates in pediatric liver transplant recipients, reduce organ rejection and provide significant cost savings with medications and hospitalizations, according to a new study. Children and adolescents who receive liver transplants often have trouble remembering to take their medication regularly; in addition to being less vigilant than adults, liver patients also suffer memory problems. Missing medication is especially dangerous since their bodies can reject the transplanted liver after only two missed doses of medication. But because young people are generally technologically savvy, researchers sought to determine whether sending text messages would result in improved adherence.

The study looked at 41 young people who were on average 15 years old and at various stages after receiving a liver transplant. The MediM AS system from CareSpeak Communications, which funded the study, was used to decide which time of day patients/or caregivers preferred to receive a medication reminder via text message, which were then sent accordingly. To ensure that patients not only received the message but also took their medication, patients had 15 minutes to send a reply text confirming intake. If they did not, MediM AS system would automatically alert their parents to follow up with their child via another text message. Researchers tracked by computer how many times patients replied, did not reply or had to have parental intervention.

To determine the effectiveness of the text reminders, researchers looked at two factors: the level of medication in the patient's blood and whether their bodies rejected the liver transplant. Patients who took medication erratically had a higher deviation of medication in their blood, compared to patients who took their medication regularly. In the year prior to the study, 12 of 41 patients experienced rejection that required hospitalization and treatment because the patient's body rejected the transplant due to improper medication dosage. But one year into this study, just two patients suffered rejection of the liver.

Lead investigator Tamir Miloh, MD, assistant professor in pediatric hepatology and surgery at Mount Sinai Hospital in New York, said that since one liver transplant for graft loss costs a few hundred thousand dollars, and with the costs associated with rejection therapy, the text reminders may help save resources and reduce complications of rejection therapy. "The implications for this study are vast because this practice could be used for many other chronic diseases," said Dr. Miloh, who is currently conducting another randomized study with more patients.

Previous studies have looked at the effectiveness of text reminders, but not on liver patients and not on a scale of this size.

Dr. Miloh will present these data on Sunday, May 31 at 2:45 p.m. CDT in South Hall, McCormick Place.

http://www.eurekalert.org/pub_releases/2009-06/aga-ldb052809.php

DDW is the largest international gathering of physicians, researchers and academics in the fields of gastroenterology, hepatology, endoscopy and gastrointestinal surgery. Jointly sponsored by the American Association for the Study of Liver Diseases, the AGA Institute, the American Society for Gastrointestinal Endoscopy and the Society for Surgery of the Alimentary Tract, DDW takes place May 30 - June 4, 2009, at the McCormick Place Convention Center. The meeting showcases approximately 5,000 abstracts and hundreds of lectures on the latest advances in GI research, medicine and technology. For more information, visit www.ddw.org.
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Clinical study results using CareSpeak’s MediM AS to be presented at the 2009 Digestive Disease Week Conference

New York City, NY and East Brunswick, NJ April 5, 2009 — Mt. Sinai Medical Center’s Pediatric Gastroenterology Department, under the leadership of Dr. Tamir Miloh, recently completed a yearlong study conducted with pediatric liver transplant patients. The study used CareSpeak’s MediM AS technology to investigate the impact of text message reminders on patients’ adherence to their medication regimen.

Successful treatment of patients after liver transplantation requires regular intake of medication and non-adherence with medication has been reported in up to 40% of adolescent orthotopic liver transplant (OLT) recipients. Non-adherence can include not taking the medication at the prescribed frequency, dose or time and can be deliberate or unintentional. Non-adherence has been associated with severe morbidity: acute/chronic rejection, end stage liver disease, hospitalizations, rising costs, re-transplantation and even death. The most common reported reason for non-adherence in OLT recipients is forgetfulness.

Improving compliance with medication is essential to improving long-term outcomes in pediatric transplant recipients. Current methods of improving adherence for chronic health problems are mostly complex and not very effective. Text messaging, also known as short messaging service (SMS), is an integral part of teenage culture and is cheap, personal, discrete, and accessible. The aims of the study were to pilot test the effects of text messaging medication reminders on patient’s adherence and outcome.

The study results will be presented at the annual Digestive Disease Week (DDW) Conference in Chicago on May 31, 2009 by Dr. Tamir Miloh. The DDW is the world’s largest gathering of physicians and researches in the fields of gastroenterology, hepatology, endoscopy and gastrointestinal surgery.

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