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Text Messaging to Promote Adherence In Cancer Patients Taking Oral Agent Medications: An Integrative Review
Oncology Nursing Society (2013)
  • Sandra Spoelstra, Grand Valley State University
Significance: A review of oral agent studies indicates less than an 80% rate of adherence; 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, hospitalization, loss of work, and, in some instances, death.
Problem & Purpose: Treatment is primarily the responsibility of patients who are prescribed oral agents. This review will discuss the foundation for developing a text message intervention and will examine evidence on text message interventions that improved adherence.
Framework: Not applicable.
Methods: Whittemore and Knafl’s review method was used, identifying studies via a search in CINAHL and PubMed using key words of text messaging and medication adherence; and reviewing of references.
Findings: 109 articles were retrieved, with 26 relevant. 9 articles met inclusion criteria. 3 articles examined adherence in those with asthma, 3 with HIV therapy, and one each for general chronic medications, immunosuppressants, and contraceptives. Total sample size was N=1,435; with 5 RCTs, 3 clinical trials, and one secondary analysis. Medication adherence improved in 8 of 9 studies. Adherence was measured by self-report, electronic means, pill counts, and pharmacy claims. Interventions included: standardized (same repeatedly) and tailored texts (specific to needs or selected by medication patient) with some requiring a response text; if varied messages if patient was adherent or non-adherent; and a scripted text to focus on attitudes and beliefs. Four studies that included receptivity measures found that the text message intervention was liked by participants and easy to use. 
Implications: Findings indicate a text messaging intervention, especially those that are two-way (requiring a response text), is a means of improving medication adherence in multiple diseases, and thus, may be effective in improving adherence in cancer patients who are prescribed treatment in pill form. Approximately 67.5% of adults own cell phones; 98% of those phones have text capability; and 60% use text message. This evidence supports exploring text messages as an intervention to promote adherence to oral agents; and whether lasting behavior modifications can be achieved using text messaging in adult oncology patients.
Publication Date
Summer 2013
Citation Information
Sandra Spoelstra. "Text Messaging to Promote Adherence In Cancer Patients Taking Oral Agent Medications: An Integrative Review" Oncology Nursing Society (2013)
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