Adolescent Chronic Disease: How Can We Help?

Think back to your 16th, 17th, or 18th birthday. The primary emotion was probably excitement, right? You were so close to the possibility of having your license and driving, college was fast approaching, and all of the freedom of senior year was right around the corner. These changes brought some challenges with them. Driving your friends or siblings was a huge responsibility, it seemed all too easy to make a mistake during the complex college application process, and it was harder than ever to balance school and activities. Now, imagine trying to juggle all of the elements of adolescent life after your doctor tells you you have Sickle Cell Anemia, Type 1 Diabetes, or Asthma. Suddenly, your whole world changes, and your priorities shift. You're not just wondering if you're going to pass your driving test. You're also wondering if moving away for college is even an option with your disease. At an age where all of your friends are finding themselves more independent than ever you are suddenly even more dependent on your family and physicians. Your doctors complicate this situation even further by saying that you should really think about transitioning from pediatrics to adult care because your 18th birthday is looming. Lump all of this together and you are an overwhelmed teenager who is confused and betrayed by the symptoms felt by your body, lost in a healthcare system that provides little support.

Overall, at least 12% of all adolescents are currently living with a chronic condition. Evidence shows that the prevalence of asthma, diabetes (Type 1), and Inflammatory Bowel Disease are all rising, along with other conditions. Additionally, most of these illnesses are complicated by the growing incidence of childhood obesity in our country. Yet, as a healthcare system we overlook one of our most at-risk populations as they simultaneously transition from pediatrics to adult care and from high school to college.

Remember arriving at college freshman year? It was hard enough figuring out how to live on your own, choose the right classes, find a friend group, and finally master the task of laundry. The adolescent chronic disease population faces all of the challenges of college freshmen with additional questions: “Where will I find a new doctor? How will I travel to my appointments? How do I negotiate with my insurance company? Do I tell my roommate about my disease? What if I need to go to the ER? What if my friends make me drink?" These teens are thrown head-first into the unknown. They have often been battling these conditions since childhood with their parents handling all of their health care. They have had very minimal exposure to insurance companies and pharmacies, and might never have visited their doctor alone before. Add in the stress of undergraduate education and social pressures, and the results will be poor health maintenance and lapses in care. In such a challenging setting, what can we, as health care professionals, do to ensure that chronically ill adolescents maintain their health, quality of life, and involvement in their own care?

balancing-stress V2
balancing-stress V2

The answer might be sitting on your iPhone. In an age of technology where everyone, and certainly every adolescent, carries some kind of smart device on their person at all times, information is almost too accessible. The idea of a teenage patient being able to track their medications, blood work, and various appointments in real time could dramatically change their health outcomes by increasing compliance. Imagine scheduling Thanksgiving break in your Google Calendar and being reminded the day before, while you’re packing, to grab your medications and make sure you take them home with you. Imagine receiving an e-mail every 3 months with your blood work prescription already attached for easy access at the lab. Better yet, imagine a system that provides teens with positive reinforcement after they complete these tasks, increasing compliance even further. Something as simple as an app can allow adolescents to take a central element of their lives, their smart phones, and use them to take control of their healthcare.

Aside from letting adolescent patients take personal charge and responsibility, these apps could also provide tremendous advancements in the realms of education and prevention. With the developments in primary care, telehealth, and patient-centered medical homes, an app that allows a patient to input his or her symptoms and be connected to an appropriate member of a medical team to discuss care options is becoming more feasible each and every day. This asset would allow teens who are still trying to gain an understanding of their illnesses to distinguish between benign and harmful incidences. What better way to get teens to the doctor than via FaceTime? Additionally, these applications could link to emergency services, protecting patients when they are alone in their dorm room or the RA is out of earshot. Upon admission to the hospital, the app could alert the teen’s medical team and family, allowing proper access to the patient's history and providing an immediate support system for the teen.

Iphone picture V2
Iphone picture V2

Apps targeted towards patients with chronic illnesses have already shown success, particularly in the Diabetes population; however, these apps or web-based programs tend to integrate only 1 or 2 key features, namely food logs or physical activity monitoring. Producing and integrated app of this magnitude will certainly not be easy. However, no one could benefit from this technology as much as the adolescent patient population; teens are the most connected age group. If anyone seeks to develop an app that could actually function within a patient's life, a teenage focus group is the place to start. We need to utilize their knowledge as a resource and work with app developers and national societies to implement feasible change within their lifestyles. Only by learning from these teens will we actually learn what is best for them.

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About The Author

Carly Sokach is a medical student in the Sidney Kimmel Medical College Class of 2019.


Boy With Inhaler - Asthma & Allergy Associates.