1. Implications for Practice
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.
Total sample size was N=2,516
7 RCTs, 2 prospective single group cohorts, 2 quasi-experimental 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.
Search Strategy
Results of Search
Implications for Practice
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.
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