Novel Tool to Monitor Adherence to Oral Oncolytics: A Pilot Study

2021 ◽  
pp. 701-708
Author(s):  
Wendy Sun ◽  
Rebecca Reeve ◽  
Timothy Ouellette ◽  
Martha Stutsky ◽  
Rachel De Jesus ◽  
...  
Keyword(s):  
Pilot Study ◽  
Real Time ◽  
Text Messaging ◽  
Text Message ◽  
Post Intervention ◽  
Chemotherapy Agent ◽  
Novel Technology ◽  
Cyclical Regimen ◽  
Oral Oncolytics ◽  
Future Work

PURPOSE Nonadherence is a significant issue in cancer care, especially as more oral therapies become available. Measuring and optimizing adherence to such therapies is challenging. In this study, we tested a novel technology that records real-time medication-taking behavior from a smart prescription bottle and can communicate with patients via text message to intervene in cases of nonadherence. METHODS We conducted a 28-patient pilot study to assess the feasibility of this technology in measuring and improving adherence in patients taking capecitabine, an oral chemotherapy agent with a complex, cyclical regimen. The study had a preintervention stage, during which patients were monitored, and an intervention stage, during which the text messaging intervention was enabled. RESULTS During preintervention, patients had an average self-adherence of 89%, and during post intervention, they had an average adherence of 90%. We defined three categories of patients by change in adherence: category 1 (> 8%), category 2 (−8% to 8%), and category 3 (< −8%). Patients in category 1 tended to live in regions with lower average household income (mean = $58,937 in US dollars [USD]) than those in category 2 (mean = $77,482 USD) and category 3 (mean = $90,972 USD). Of poststudy survey respondents, most indicated that they would want to continue using this technology and that they would recommend it to others. CONCLUSION This novel technology is able to monitor, measure, and intervene for patients taking capecitabine in real time. Adherence overall was high, and some patients appeared to benefit more from text-message interventions. Future work should focus on patients deemed high risk for nonadherence.

A novel tool to monitor adherence to oral oncolytics: A pilot study.

2019 ◽  
Vol 37 (27_suppl) ◽  
pp. 286-286
Author(s):  
Wendy Sun ◽  
Rebecca Reeve ◽  
Timothy Ouellette ◽  
Martha Stutsky ◽  
Rachel De Jesus ◽  
...  
Keyword(s):  
Pilot Study ◽  
Real Time ◽  
Text Messaging ◽  
Text Message ◽  
Innovative Technology ◽  
Chemotherapy Agent ◽  
Average Household Income ◽  
Cyclical Regimen ◽  
Oral Oncolytics ◽  
Future Work

286 Background: Non-adherence is an important issue in cancer care as more oral cytotoxic and targeted agents become available. Although oral therapies may be more convenient for patients, measuring and optimizing adherence is challenging. The Nomi system records real-time medication taking behavior from a "smart" prescription bottle and displays the data on a web-based interface. Nomi can also communicate with patients via text message to intervene in cases of non-adherence. We report the results of a 28-patient pilot study aiming to assess Nomi’s ability to assist patients taking capecitabine, an oral chemotherapy agent with a complex, cyclical regimen. Methods: Eligible patients were prescribed capecitabine for breast, colorectal, pancreatic, or biliary cancer. The study had a pre-intervention stage, during which patients were monitored, and an intervention stage, in which the text messaging feature was enabled. Adherence was defined as the number of correct doses (both timing and quantity) over the total number of prescribed doses. Conversions were events in which patients took a dose after receiving a text intervention (from Nomi). We defined three categories of patients by percent change in adherence: category 1 ( > 8%), category 2 (-8% to 8%), and category 3 ( < -8%). Results: We collected data from 28 patients (24 pre/post and 4 pre-only). On average, patients were 84% adherent (N = 28; SD = 11%). During pre-intervention, patients had a self-adherence of 89% (SD = 12%), and afterwards, they had an average adherence of 90% (SD = 6%). Most of the patients in category 1 demonstrated a substantial conversion rate ( > 35%). Patients in category 1 tended to live in regions with lower average household income (Mean = $58,937) than those in category 2 (Mean = $77,482) and category 3 (Mean = $90,972). Of survey respondents, 56% indicated that they would want to continue using Nomi, while 67% indicated that they would recommend it to others. Conclusions: This innovative technology is able to monitor, measure and intervene for patients taking capecitabine in real-time. Adherence overall was high, and some patients appeared to benefit more from text message interventions. Future work should focus on patients deemed high risk for non-adherence.

scholarly journals A Mobile Health Intervention for Adolescents Exposed to Secondhand Smoke: Pilot Feasibility and Efficacy Study

10.2196/18583 ◽  
2020 ◽  
Vol 4 (8) ◽  
pp. e18583
Author(s):  
Natalie Nardone ◽  
Jeremy Giberson ◽  
Judith J Prochaska ◽  
Shonul Jain ◽  
Neal L Benowitz
Keyword(s):  
Pilot Study ◽  
Mobile Health ◽  
Secondhand Smoke ◽  
Text Messaging ◽  
Text Message ◽  
Preliminary Evidence ◽  
Text Messages ◽  
Urinary Cotinine ◽  
Mhealth Intervention ◽  
Shs Exposure

Background Secondhand smoke (SHS) exposure in children and adolescents has adverse health effects. For adolescents of lower socioeconomic status (SES), exposure is widespread, evidenced in the measurement of urinary cotinine, a major metabolite of nicotine. Direct intervention with exposed children has been proposed as a novel method, yet there is minimal evidence of its efficacy. Combining this approach with a mobile health (mHealth) intervention may be more time and cost-effective and feasible for adolescent populations. Objective In this pilot study, we assessed the feasibility and preliminary evidence of efficacy of a 30-day text message–based mHealth intervention targeted at reducing SHS exposure in adolescent populations of low SES. Methods For the study, 14 nonsmoking and nonvaping participants between the ages of 12-21 years exposed to SHS were enrolled. The intervention consisted of a daily text message sent to the participants over the course of a month. Text message types included facts and information about SHS, behavioral methods for SHS avoidance, or true-or-false questions. Participants were asked to respond to each message within 24 hours as confirmation of receipt. Feasibility outcomes included completion of the 30-day intervention, receiving and responding to text messages, and feedback on the messages. Efficacy outcomes included a reduction in urinary cotinine, accuracy of true-or-false responses, and participants’ perceptions of effectiveness. Results Of the 14 participants that were enrolled, 13 completed the intervention. Though not required, all participants had their own cell phones with unlimited text messaging plans. Of the total number of text messages sent to the 13 completers, 91% (372/407) of them received on-time responses. Participant feedback was generally positive, with most requesting more informational and true-or-false questions. In terms of efficacy, 54% (6/11) of participants reduced their cotinine levels (however, change for the group overall was not statistically significant (P=.33) and 45% (5/11) of participants increased their cotinine levels. Of the total number of true-or-false questions sent across all completers, 77% (56/73) were answered correctly. Participants’ ratings of message effectiveness averaged 85 on a scale of 100. Conclusions In this pilot study, the intervention was feasible as the majority of participants had access to a cell phone, completed the study, and engaged by responding to the messages. The efficacy of the study requires further replication, as only half of the participants reduced their cotinine levels. However, participants answered the majority of true-or-false questions accurately and reported that the messages were helpful.

scholarly journals Text Message Medication Adherence Reminders Automated and Delivered at Scale Across Two Institutions: Testing the Nudge System: Pilot Study

2021 ◽  
Author(s):  
Phat Luong ◽  
Thomas J. Glorioso ◽  
Gary K. Grunwald ◽  
Pamela Peterson ◽  
Larry A. Allen ◽  
...  
Keyword(s):  
Medication Adherence ◽  
Pilot Study ◽  
Phase I ◽  
Phase Ii ◽  
Text Messaging ◽  
Care Delivery ◽  
Text Message ◽  
Text Messages ◽  
Medication Refill ◽  
The Impact

Background: Medication refill behavior in patients with cardiovascular diseases is suboptimal. Brief behavioral interventions called Nudges may impact medication refill behavior and can be delivered at scale to patients using text messaging. Methods: Patients who were prescribed and filled at least one medication for hypertension, hyperlipidemia, diabetes, atrial fibrillation, and coronary artery disease were identified for the pilot study. Patients eligible for the pilot (N=400) were enrolled with an opportunity to opt out. In phase I of the pilot, we tested text message delivery to 60 patients. In phase II, we tested intervention feasibility by identifying those with refill gap of ≥7 days and randomized them to intervention or control arms. Patients were texted Nudges and assessed whether they refilled their medications. Results: Of 400 patients sent study invitations, 56 (14%) opted out. In phase I, we successfully delivered text messages to 58 of 60 patients and captured patient responses via text. In phase II, 207 of 286 (72.4%) patients had a medication gap ≥7 days for one or more cardiovascular medications and were randomized to intervention or control. Enrolled patients averaged 61.7 years old, were primarily male (69.1%) and White (72.5%) with hypertension being the most prevalent qualifying condition (78.7%). There was a trend towards intervention patients being more likely to refill at least 1 gapping medication (30.6% versus 18.0%; P =0.12) and all gapping medications (17.8% versus 10.0%; P =0.27). Conclusions: It is possible to set up automated processes within health care delivery systems to identify patients with gaps in medication adherence and send Nudges to facilitate medication refills. Text message Nudges could potentially be a feasible and effective method to facilitate medication refills. A large multi-site randomized trial to determine the impact of text-based Nudges on overall CVD morbidity and mortality is now underway to explore this further. REGISTRATION: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT03973931.

Mobile-phone text messaging (SMS) for providing oral health education to mothers of preschool children in Belgaum City

2011 ◽  
Vol 17 (8) ◽  
pp. 432-436 ◽  
Author(s):  
Ratika Sharma ◽  
Mamata Hebbal ◽  
Anil V Ankola ◽  
Vikneshan Murugabupathy
Keyword(s):  
Preschool Children ◽  
Oral Health ◽  
Health Education ◽  
Text Messaging ◽  
Effective Means ◽  
Text Message ◽  
Text Messages ◽  
Post Intervention ◽  
Plaque Score ◽  
Oral Health Education

We compared the effectiveness of two media (text messages and pamphlets) in imparting health education to mothers of preschool children. Mothers and their children were randomized into two groups. There were 72 mothers and their children in the pamphlet group and 71 in the text message group. The mothers were given health education by one of the two modes for four weeks. Knowledge, attitude and practices of the mothers were assessed by a questionnaire pre- and post-intervention. Visible plaque scores of their children were also recorded pre- and post-intervention. There were significant improvements in knowledge ( P < 0.001), attitude ( P < 0.001) and practices ( P < 0.001) in both groups. There was also a significant reduction in visible plaque scores ( P < 0.001) in both groups. Text messaging was more effective than pamphlets in improving knowledge, attitude and practices of mothers, but the comparative reduction in plaque score between groups was not significant. Text messaging appears to be an effective means of imparting oral health education.

scholarly journals Combining Real-Time Ratings With Qualitative Interviews to Develop a Smoking Cessation Text Messaging Program for Primary Care Patients (Preprint)

2018 ◽  
Author(s):  
Gina Kruse ◽  
Elyse R Park ◽  
Naysha N Shahid ◽  
Lorien Abroms ◽  
Jessica E Haberer ◽  
...  
Keyword(s):  
Primary Care ◽  
Real Time ◽  
Text Messaging ◽  
Qualitative Interviews ◽  
Text Message ◽  
Intervention Development ◽  
Text Messages ◽  
Behavioral Skills ◽  
Message Service ◽  
Primary Care Patients

BACKGROUND Text messaging (short message service, SMS) interventions show promise as a way to help cigarette smokers quit. Few studies have examined the effectiveness of text messaging (SMS) programs targeting smokers associated with primary care or hospital settings. OBJECTIVE This study aimed to develop a text messaging (SMS) program targeting primary care smokers. METHODS Adult smokers in primary care were recruited from February 2017 to April 2017. We sent patients 10 to 11 draft text messages (SMS) over 2 days and asked them to rate each message in real time. Patients were interviewed daily by telephone to discuss ratings, message preferences, and previous experiences with nicotine replacement therapy (NRT). Content analysis of interviews was directed by a step-wise text messaging (SMS) intervention development process and the Information-Motivation-Behavioral Skills model of medication adherence. RESULTS We sent 149 text messages (SMS) to 15 patients. They replied with ratings for 93% (139/149) of the messages: 134 (96%, 134/139) were rated as clear or useful and 5 (4%, 5/139) as unclear or not useful. Patients’ preferences included the addition of graphics, electronic cigarette (e-cigarette) content, and use of first names. Regarding NRT, patients identified informational gaps around safety and effectiveness, preferred positively framed motivational messages, and needed behavioral skills to dose and dispose of NRT. CONCLUSIONS Patients recommended text message (SMS) personalization, inclusion of e-cigarette information and graphics, and identified barriers to NRT use. Combining real-time ratings with telephone interviews is a feasible method for incorporating primary care patients’ preferences into a behavioral text messaging (SMS) program.

scholarly journals A Mobile Health Intervention for Adolescents Exposed to Secondhand Smoke: Pilot Feasibility and Efficacy Study (Preprint)

2020 ◽  
Author(s):  
Natalie Nardone ◽  
Jeremy Giberson ◽  
Judith J Prochaska ◽  
Shonul Jain ◽  
Neal L Benowitz
Keyword(s):  
Pilot Study ◽  
Mobile Health ◽  
Secondhand Smoke ◽  
Text Messaging ◽  
Text Message ◽  
Preliminary Evidence ◽  
Text Messages ◽  
Urinary Cotinine ◽  
Mhealth Intervention ◽  
Shs Exposure

BACKGROUND Secondhand smoke (SHS) exposure in children and adolescents has adverse health effects. For adolescents of lower socioeconomic status (SES), exposure is widespread, evidenced in the measurement of urinary cotinine, a major metabolite of nicotine. Direct intervention with exposed children has been proposed as a novel method, yet there is minimal evidence of its efficacy. Combining this approach with a mobile health (mHealth) intervention may be more time and cost-effective and feasible for adolescent populations. OBJECTIVE In this pilot study, we assessed the feasibility and preliminary evidence of efficacy of a 30-day text message–based mHealth intervention targeted at reducing SHS exposure in adolescent populations of low SES. METHODS For the study, 14 nonsmoking and nonvaping participants between the ages of 12-21 years exposed to SHS were enrolled. The intervention consisted of a daily text message sent to the participants over the course of a month. Text message types included facts and information about SHS, behavioral methods for SHS avoidance, or true-or-false questions. Participants were asked to respond to each message within 24 hours as confirmation of receipt. Feasibility outcomes included completion of the 30-day intervention, receiving and responding to text messages, and feedback on the messages. Efficacy outcomes included a reduction in urinary cotinine, accuracy of true-or-false responses, and participants’ perceptions of effectiveness. RESULTS Of the 14 participants that were enrolled, 13 completed the intervention. Though not required, all participants had their own cell phones with unlimited text messaging plans. Of the total number of text messages sent to the 13 completers, 91% (372/407) of them received on-time responses. Participant feedback was generally positive, with most requesting more informational and true-or-false questions. In terms of efficacy, 54% (6/11) of participants reduced their cotinine levels (however, change for the group overall was not statistically significant (<i>P</i>=.33) and 45% (5/11) of participants increased their cotinine levels. Of the total number of true-or-false questions sent across all completers, 77% (56/73) were answered correctly. Participants’ ratings of message effectiveness averaged 85 on a scale of 100. CONCLUSIONS In this pilot study, the intervention was feasible as the majority of participants had access to a cell phone, completed the study, and engaged by responding to the messages. The efficacy of the study requires further replication, as only half of the participants reduced their cotinine levels. However, participants answered the majority of true-or-false questions accurately and reported that the messages were helpful.

Adherence to remote versus clinic-based collection of patient-reported outcomes in patients with advanced lung cancer.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e14109-e14109
Author(s):  
Peter Edward Gabriel ◽  
Tara L. Kaufmann ◽  
Abigail N. Blauch ◽  
Donna A. Pucci ◽  
Linda A. Jacobs ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Pilot Study ◽  
Real Time ◽  
Text Messaging ◽  
Patient Reported Outcomes ◽  
Advanced Nsclc ◽  
Text Messages ◽  
Advanced Lung Cancer ◽  
Small Pilot Study ◽  
Patient Reported

e14109 Background: Routine collection of patient-reported outcomes (PROs) is an evidence-based practice to improve communication, symptom management, and health outcomes in cancer care. However, optimal implementation strategies are poorly understood. Previous studies have mostly assessed PROs collected during clinic visits, which may be less actionable and more subject to recall bias than those collected in real time. Behavioral economics-informed digital approaches have shown increasing promise as sustainable and scalable strategies for remote patient monitoring. We compared remote text-messaging versus usual clinic-based PRO collection approaches. Methods: Between September 2018 and May 2019, we conducted a prospective pilot feasibility study of remote PRO monitoring via text-messaging among 20 patients with advanced non-small cell lung cancer (NSCLC). Pilot participants consented to enroll in a HIPAA-compliant, bidirectional text-messaging platform, which allowed for direct reporting of PRO measures at home. Data were integrated into the electronic health record in real time, and clinicians were notified of severe or escalating symptoms. We compared patient-level adherence over 12 weeks among: 1) pilot participants and 2) patients with advanced NSCLC reporting via usual clinic-based collection methods. We identified predictors of adherence using multivariable logistic regression, and surveyed pilot participants on feasibility outcomes. Results: During the study period, 20 patients with advanced NSCLC participated in the remote text-messaging pilot study (mean age, 63y; 60% male; 85% white), and 328 patients with advanced NSCLC participated in usual clinic-based PRO collection (mean age, 66y; 48% male; 69% white). Baseline characteristics were similar between groups. Mean adherence was 88.4% for remote text-messaging vs 71.2% for clinic-based collection (p < 0.001). Pilot participation predicted > 80% adherence after adjusting for age, sex, race, and marital status (OR 3.5, p = 0.029). Pilot participants reported high levels of usability (97%) and satisfaction (96%) with text-messaging, and 90% noted that text messages reminded them to report symptoms to their clinical team. Conclusions: Among patients with advanced NSCLC, remote PRO monitoring via text-messaging was feasible and enabled significantly higher adherence to reporting than usual clinic-based collection. These results are based on a small pilot study, and further research on text messaging as a PRO implementation strategy is warranted. Clinical trial information: NCT03616522.

scholarly journals Assessing the acceptability of a text messaging service and smartphone app to support patient adherence to medications prescribed for high blood pressure: a pilot study.

2020 ◽  
Author(s):  
Aikaterini Kassavou ◽  
Charlotte A Court ◽  
Jagmohan Chauhan ◽  
James Brimicombe ◽  
Debbi Bhattacharya ◽  
...  
Keyword(s):  
Primary Care ◽  
Pilot Study ◽  
Text Messaging ◽  
Patient Adherence ◽  
Text Message ◽  
Drop Out ◽  
Smartphone App ◽  
Delivery Mode ◽  
Log Files ◽  
Intervention Content

Abstract Aims and objectives. This paper describes the pilot study of a highly tailored text message and smartphone app intervention to increase adherence to anti-hypertensive medication in primary care. The aim of this study was to evaluate the acceptability of the intervention and obtain patients views about the intervention content, the delivery mode, and the mechanisms by which the intervention supported medication adherence. Methods. Patients diagnosed with hypertension were invited to the study via general practice text message invitation and recruited face to face by the researcher team. Participants tested the text message intervention for 28 or the text message followed by the app for 56 days. Participants completed baseline and follow up questionnaires and took part in a weekly or end of intervention telephone interviews. Digital log files captured patients’ usage of the intervention. Participant transcripts were analysed using thematic analysis. Descriptive statistics were used to summarize data from questionnaires and log files. A mixed methods analysis generated data to respond to the research questions. Results. 79 patients expressed their interest to participate in this study and 23 of these patients were recruited to take part. With one drop-out, 22 participants tested the text message delivery mode (with 20 being interviewed) and four requested to switch to the app (with 3 being interviewed). All participants used and engaged with the text message and app notifications, and most participants found the intervention content and delivery mode acceptable. They also self-reported that the intervention supported them to take their medications as prescribed. Conclusion. This study provides evidence that the digital intervention is acceptable by hypertensive patients recruited in primary care, thus it should be tested for its effectiveness using rigorous research methods. ISRCTN12805654 https://doi.org/10.1186/ISRCTN12805654

scholarly journals MyVoice National Text Message Survey of Youth Aged 14 to 24 Years: Study Protocol (Preprint)

2017 ◽  
Author(s):  
Melissa DeJonckheere ◽  
Lauren P Nichols ◽  
Michelle H Moniz ◽  
Kendrin R Sonneville ◽  
VG Vinod Vydiswaran ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Real Time ◽  
Language Processing ◽  
Text Messaging ◽  
Research Team ◽  
Qualitative Data ◽  
Text Message ◽  
Well Being ◽  
Minimal Risk ◽  
Policy Makers

BACKGROUND There has been little progress in adolescent health outcomes in recent decades. Researchers and youth-serving organizations struggle to accurately elicit youth voice and translate youth perspectives into health care policy. OBJECTIVE Our aim is to describe the protocol of the MyVoice Project, a longitudinal mixed methods study designed to engage youth, particularly those not typically included in research. Text messaging surveys are collected, analyzed, and disseminated in real time to leverage youth perspectives to impact policy. METHODS Youth aged 14 to 24 years are recruited to receive weekly text message surveys on a variety of policy and health topics. The research team, including academic researchers, methodologists, and youth, develop questions through an iterative writing and piloting process. Question topics are elicited from community organizations, researchers, and policy makers to inform salient policies. A youth-centered interactive platform has been developed that automatically sends confidential weekly surveys and incentives to participants. Parental consent is not required because the survey is of minimal risk to participants. Recruitment occurs online (eg, Facebook, Instagram, university health research website) and in person at community events. Weekly surveys collect both quantitative and qualitative data. Quantitative data are analyzed using descriptive statistics. Qualitative data are quickly analyzed using natural language processing and traditional qualitative methods. Mixed methods integration and analysis supports a more in-depth understanding of the research questions. RESULTS We are currently recruiting and enrolling participants through in-person and online strategies. Question development, weekly data collection, data analysis, and dissemination are in progress. CONCLUSIONS MyVoice quickly ascertains the thoughts and opinions of youth in real time using a widespread, readily available technology—text messaging. Results are disseminated to researchers, policy makers, and youth-serving organizations through a variety of methods. Policy makers and organizations also share their priority areas with the research team to develop additional question sets to inform important policy decisions. Youth-serving organizations can use results to make decisions to promote youth well-being.

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