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Development of a Smartphone Program to Support Adherence to Oral Chemotherapy in People with Cancer

Authors Skrabal Ross X, Gunn KM, Patterson P, Olver I

Received 1 August 2019

Accepted for publication 30 October 2019

Published 20 December 2019 Volume 2019:13 Pages 2207—2215


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Johnny Chen

Xiomara Skrabal Ross,1,2 Kate M Gunn,1,3 Pandora Patterson,4,5 Ian Olver6

1Cancer Research Institute, University of South Australia, Adelaide, South Australia, Australia; 2School of Health Sciences, University of South Australia, Adelaide, South Australia, Australia; 3Department of Rural Health, University of South Australia, Adelaide, South Australia, Australia; 4Faculty of Nursing, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia; 5Research and Youth Cancer Services, CanTeen Australia, Sydney, New South Wales, Australia; 6Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia

Correspondence: Kate M Gunn
University of South Australia, City West Campus, HB Building, 8-25, Adelaide, South Australia, Australia
Tel +61 8 830 22137

Purpose: To describe the theoretical, evidence-based and consumer-informed development of a smartphone self-management program aiming to support adherence to oral chemotherapy in adolescents and adults diagnosed with cancer.
Methods: The design of the program followed two frameworks for the development and evaluation of mHealth interventions and was conducted in three steps: 1) conceptualization, which involved an extensive literature review and a scoping review that led to the identification of the behavioral change strategies in the program; 2) definition of features and structure, based on a formative study with end-users to explore their preferences about the structure and elements of the program; and 3) selection of program delivery technology, whereby available technology platforms were examined and the most suitable tool to deliver the program was selected.
Results: Three main reasons for oral chemotherapy non-adherence were identified: forgetfulness, side-effects and poor knowledge about oral chemotherapy. Key behavior change strategies were also identified, namely, medication intake reminders and information about oral chemotherapy and managing side-effects. Based upon end-user feedback the method of delivery of these behavioral strategies that was deemed most appropriate was conventional text messages. The reminders were standard, short, text-only messages sent when each oral chemotherapy dose was due, one way (no need to reply) and addressed the end-users using their first name. Delivery of information about oral chemotherapy and side-effects was tailored to each individual’s preferred frequency.
Conclusion: The careful design process described in this paper may serve to inform the development of future mobile phone-based medication adherence-enhancing interventions for people with cancer. A trial to explore end-users acceptability of and satisfaction with the intervention is currently underway.
Trial Registration: ACTRN12618001987257p.

Keywords: oral chemotherapy, medication adherence, mobile phone, smartphone, text messages, cancer

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