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Text Messaging to Promote Adherence In Cancer Patients Taking Oral Agent Medications An Integrative Review Sandra Spoelstra, PhD, RN1; Tracy DeKoekkoek, RN1; Charles W. Given, PhD2; Kimberly Ridenour, Nurse Scholar1; Monica Schueller, BA1; and Barbara Given, PhD, RN, FAAN1 Problem & Purpose Synthesis of Evidence A review of oral agent studies indicates there is less than an 80% adherence rate; and 10% of those newly prescribed oral agents stop taking their medication. Lack of adherence to oral anti-cancer agents is a significant clinical problem that may result in treatment failure. Patients who are prescribed oral agents are now responsible for their treatment. This review will discuss the foundation for developing a text message intervention and will examine evidence on text message interventions that improved adherence. Search Strategy Results of Search Whittemore and Knafl’s integrative review method was used. A literature search was conducted using CINAHL, PubMed, and Psych Info. Using search terms: “text messaging/message,” “medication adherence,” and “intervention” during 2003 to 2013. 55 articles were retrieved, with 25 relevant. 13 articles met inclusion criteria: 6 in HIV therapy 2 in schizophrenia 1 each in chronic medication management (heart disease, depression, diabetes, thyroid, osteoarthritis); contraceptives; epilepsy; antibiotics; and diabetes. Total sample size was N=2,516 7 RCTs, 2 prospective single group cohorts, 2 quasiexperimental studies, 1 retrospective matched cohort study, and 1 Cochrane review. Medication adherence improved in 9 of 13 studies. Adherence was measured by self-report, electronic means, pill counts, visual analogue scale, and pharmacy claims. Interventions included: standardized (same repeatedly) and tailored texts (specific to needs or selected by patient) with some requiring a response text; varied text frequency (daily, weekly, or monthly); short versus long text messages; and scripted text to focus on education, motivation, attitudes, and beliefs. Implications for Practice A text intervention, especially two-way (requiring a response text), is a means of improving medication adherence in multiple diseases; and may be effective in cancer patients who are prescribed treatment in pill form. Text messages may promote adherence to oral agents in adult cancer patients. 1 College of Nursing; 2 Family Medicine, Michigan State University, East Lansing, MI