Download Text Messaging to Promote Adherence In Cancer Patients Taking

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