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Text Messaging Application Helpful with Adherence to Endocrine Therapy

TOP - May 2016, Vol 9, No 2

San Antonio, TX—An interactive text messaging tool to assess adherence to adjuvant endocrine therapy for breast cancer and to deliver direct communication to providers was found helpful by the majority of patients, said Lianne Epstein, MPH, at the 2015 San Antonio Breast Cancer Symposium.

The pilot study she is conducting (Breast Cancer Endocrine Therapy Adherence [BETA]) has found so far that three-fourths of patients believed that the daily text messages served as a reminder to take their endocrine therapy, and all of them said that it was easy to use.

“After 3 months of daily text messages, 70% of patients wanted to continue using the text messages and enjoyed having a daily reminder,” said Ms Epstein, Clinical Research Coordinator, Breast Medical Oncology Group at Yale Cancer Center, New Haven, CT. “It seems to be a new approach that resonated with patients.”

Patients were eligible if they had stage I to III, hormone receptor–positive breast cancer, owned a cell phone, and were initiating endocrine therapy. Of the 148 patients who were approached, 100 agreed to use the BETA study text messaging tool.

Three main text messages were delivered for 3 months. First, patients received a daily text asking them if they had taken their medication, to which they responded “Y” or “N.”

Second, patients were asked weekly about adverse events and their severity, and were referred to clinic triage nurses if necessary.

Third, once a month patients received a text message asking if they faced any barriers to taking their endocrine therapy, including financial.

After 3 months, patients completed surveys assessing the tolerability and financial burden of the intervention and adherence to medication. The average rate of responding to the text messages was 88%. The average adherence rate was 87%, with 88% of the study participants achieving adherence rates of ≥80%.

All 100 patients answered that they found the application easy to use, 96% agreed that it helped with their breast cancer treatment, and 96% indicated that the application helped them take their medications. None said that the cost of the text messages was too high, and only 4% said that using it took up too much time; 27% of the respondents said that their current treatment posed a financial hardship.

In looking at the behavior of 100 consecutive historical controls, 7% were found to have discontinued endocrine therapy within 3 months, said Ms Epstein. In this study, 5% of patients discontinued endocrine therapy before 3 months, 2% of patients never started, and 1 patient had progression of disease during the study.

Further evaluation in a randomized controlled study to assess improvements in adherence is planned.

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