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New Study Finds Text-Messaging Reminders Effective in Improving Adherence to Sunscreen Use

SAN FRANCISCO, March 5 /PRNewswire-USNewswire/ -- Despite dermatologists' continual efforts, a disconnect persists between the public's understanding of the harmful effects of excessive sun exposure and regular use of sunscreen as part of an overall sun-protection strategy to reduce the risk of developing skin cancer. But now, the same technology that keeps people connected 24/7 may help encourage them to apply sunscreen regularly via daily text messaging reminders.

Speaking today at the 67th Annual Meeting of the American Academy of Dermatology (Academy), dermatologist Joseph C. Kvedar, MD, FAAD, associate professor of dermatology at Harvard University Medical School in Boston, presented findings of his study that showed text messaging reminders were effective in improving sunscreen usage.

"For most people, cell phones, e-mail and text messaging are an integral part of how they communicate with one another and an ideal channel for health care professionals to reach patients with important reminders on taking their daily medications or even applying sunscreen," said Dr. Kvedar. "Our study was designed to determine if, in fact, daily text-messaging reminders encouraging people to apply sunscreen resulted in increased sunscreen usage."

Since few innovations exist that accurately measure adherence to products such as sunscreen and no reminder system is currently available to improve sunscreen adherence in the general population, the Center for Connected Health - a division of Partners Healthcare in Boston - developed a reminder service in which study subjects were sent cell phone text messages reminding them to apply their sunscreen.

This novel technology was evaluated in a randomized controlled trial in the fall of 2008 to test the effect of these reminders on the frequency of sunscreen application. Seventy patients ranging in age from 18 to 72 participated in the study and were asked to apply sunscreen daily for six weeks. Half of the patients were randomly selected to receive text messages via cellular phones and the other half did not receive reminders. Text message reminders were sent to participants each morning around 7 a.m., which stated the weather report and a reminder to apply sunscreen.

Dr. Kvedar evaluated patients' adherence to daily sunscreen usage with a novel electronic monitoring device, which was strapped onto the tube of sunscreen. When the cap of the sunscreen tube was removed, the device sent a text message to researchers that was then recorded as evidence of sunscreen use.

At the end of the study period, Dr. Kvedar concluded that the subjects receiving text messages had a significantly improved rate of sunscreen application as compared to the control subjects. Specifically, the 35 subjects who received daily text message reminders to apply sunscreen had a mean daily adherence rate of 56 percent compared to a mean daily adherence rate of only 30 percent by the 35 subjects who did not receive reminders.

"The results of this study were dramatic, and we are encouraged by the positive feedback we received from subjects who received the reminders and applied sunscreen as a result," said Dr. Kvedar. "The implications of this study extend well beyond sunscreen use to any situation where a reminder to adhere to a care plan would be useful to patients - such as taking once-a-day medications or dressing changes for post-surgery patients."

Among the patients in the reminder group, 68.6 percent reported that they would keep using the text message reminders after the study and 88.6 percent reported that they would recommend the text messaging reminder system to others.

The Academy recommends using the following guidelines when wearing sunscreen as part of a sun-protection regimen:

  • Generously apply water-resistant sunscreen with a Sun Protection Factor (SPF) of at least 15 that provides broad-spectrum protection from both ultraviolet A (UVA) and ultraviolet B (UVB) rays to all exposed skin. Look for the AAD SEAL OF RECOGNITION(R) on products that meet these criteria.
  • Re-apply every two hours, even on cloudy days, and after swimming or sweating.

In addition to wearing sunscreen, the Academy recommends these other ways for everyone to Be Sun SmartSM:

  • Wear protective clothing, such as a long-sleeved shirt, pants, a wide-brimmed hat and sunglasses, where possible.
  • Seek shade when appropriate, remembering that the sun's rays are strongest between 10 a.m. and 4 p.m. If your shadow is shorter than you are, seek shade.
  • Protect children from sun exposure by playing in the shade, wearing protective clothing and applying sunscreen.
  • Use extra caution near water, snow and sand as they reflect the damaging rays of the sun, which can increase your chance of sunburn.
  • Get vitamin D safely through a healthy diet that may include vitamin supplements. Don't seek the sun.
  • Avoid tanning beds. Ultraviolet light from the sun and tanning beds can cause skin cancer and wrinkling. If you want to look like you've been in the sun, consider using a sunless self-tanning product, but continue to use sunscreen with it.
  • Check your birthday suit on your birthday. If you notice anything changing, growing or bleeding on your skin, see a dermatologist. Skin cancer is very treatable when caught early.

Headquartered in Schaumburg, Ill., the American Academy of Dermatology (Academy), founded in 1938, is the largest, most influential, and most representative of all dermatologic associations. With a membership of more than 15,000 physicians worldwide, the Academy is committed to: advancing the diagnosis and medical, surgical and cosmetic treatment of the skin, hair and nails; advocating high standards in clinical practice, education, and research in dermatology; and supporting and enhancing patient care for a lifetime of healthier skin, hair and nails. For more information, contact the Academy at 1-888-462-DERM (3376) or

SOURCE American Academy of Dermatology
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