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Title: Mobile Health Intervention to Increase Oral Cancer Therapy Adherence in Patients With Chronic Myeloid Leukemia (The REMIND System): Clinical Feasibility and Acceptability Assessment.
Austin Authors: Pereira-Salgado, Amanda;Westwood, Jennifer A;Russell, Lahiru;Ugalde, Anna;Ortlepp, Bronwen;Seymour, John F;Butow, Phyllis;Cavedon, Lawrence;Ong, Kevin;Aranda, Sanchia;Breen, Sibilah;Kirsa, Suzanne;Dunlevie, Andrew;Schofield, Penelope
Affiliation: Centre for Nursing Research, Cabrini Institute, Malvern, Victoria, Australia
Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia
School of Nursing and Midwifery, Faculty of Health, Deakin University, Geelong, Victoria, Australia
Department of Haematology, Royal Adelaide Hospital, Adelaide, South Australia, Australia
Department of Haematology, Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia
Sir Peter MacCallum Department of Oncology, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Victoria, Australia
School of Psychology, The University of Sydney, Sydney, New South Wales, Australia
School of Science, RMIT University, Melbourne, Victoria, Australia
Cancer Council Australia, Sydney, New South Wales, Australia
Public Health Group, Stroke Division, The Florey Institute of Neuroscience and Mental Health, Heidelberg, Victoria, Australia
Pharmacy Department, Monash Health, Clayton, Victoria, Australia
Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia
Department of Psychology, School of Health Sciences, Faculty of Health, Arts and Design, Swinburne University of Technology, Hawthorn, Victoria, Australia
Issue Date: 6-Dec-2017 2017
Publication information: JMIR mHealth and uHealth 2017; 5(12): e184
Abstract: Optimal dosing of oral tyrosine kinase inhibitor therapy is critical to treatment success and survival of patients with chronic myeloid leukemia (CML). Drug intolerance secondary to toxicities and nonadherence are significant factors in treatment failure. The objective of this study was to develop and pilot-test the clinical feasibility and acceptability of a mobile health system (REMIND) to increase oral drug adherence and patient symptom self-management among people with CML (chronic phase). A multifaceted intervention was iteratively developed using the intervention development framework by Schofield and Chambers, consisting of defining the patient problem and iteratively refining the intervention. The clinical feasibility and acceptability were examined via patient and intervention nurse interviews, which were audiotaped, transcribed, and deductively content analyzed. The intervention comprised 2 synergistically operating elements: (1) daily medication reminders and routine assessment of side effects with evidence-based self-care advice delivered in real time and (2) question prompt list (QPL) questions and routinely collected individual patient adherence and side effect profile data used to shape nurses' consultations, which employed motivational interviewing to support adoption of self-management behaviors. A total of 4 consultations and daily alerts and advice were delivered over 10 weeks. In total, 58% (10/17) of patients and 2 nurses participated in the pilot study. Patients reported several benefits of the intervention: help in establishing medication routines, resolution of symptom uncertainty, increased awareness of self-care, and informed decision making. Nurses also endorsed the intervention: it assisted in establishing pill-taking routines and patients developing effective solutions to adherence challenges. The REMIND system with nurse support was usable and acceptable to both patients and nurses. It has the potential to improve adherence and side-effect management and should be further evaluated.
DOI: 10.2196/mhealth.8349
ORCID: 0000-0002-8353-8230
Journal: JMIR mHealth and uHealth
PubMed URL: 29212628
ISSN: 2291-5222
Type: Journal Article
Subjects: Internet
medication adherence
mobile phone
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