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Mobile health intervention to increase oral cancer therapy adherence in patients with chronic myeloid leukemia (the REMIND system): clinical feasibility and acceptability assessment

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 and Schofield, Penelope 2017, Mobile health intervention to increase oral cancer therapy adherence in patients with chronic myeloid leukemia (the REMIND system): clinical feasibility and acceptability assessment, JMIR mhealth and uhealth, vol. 5, no. 12, pp. 1-15, doi: 10.2196/mhealth.8349.

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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
Author(s) Pereira-Salgado, Amanda
Westwood, Jennifer A.
Russell, Lahiru
Ugalde, AnnaORCID iD for Ugalde, Anna orcid.org/0000-0002-2473-8435
Ortlepp, Bronwen
Seymour, John F.
Butow, Phyllis
Cavedon, Lawrence
Ong, Kevin
Aranda, Sanchia
Breen, Sibilah
Kirsa, Suzanne
Dunlevie, Andrew
Schofield, Penelope
Journal name JMIR mhealth and uhealth
Volume number 5
Issue number 12
Article ID e184
Start page 1
End page 15
Total pages 15
Publisher JMIR Publications
Place of publication Toronto, Ont.
Publication date 2017-12
ISSN 2291-5222
Keyword(s) Internet
medication adherence
mobile phone
neoplasms
Science & Technology
Life Sciences & Biomedicine
Health Care Sciences & Services
Medical Informatics
RANDOMIZED CONTROLLED-TRIAL
CHEMOTHERAPY-RELATED TOXICITY
IMATINIB THERAPY
CML PATIENTS
FOLLOW-UP
MANAGEMENT
OUTCOMES
METAANALYSIS
EXPERIENCES
Summary Background: 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.

Objective:
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).

Methods: 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.

Results: 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.

Conclusions:
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.
Language eng
DOI 10.2196/mhealth.8349
Field of Research 111299 Oncology and Carcinogenesis not elsewhere classified
111099 Nursing not elsewhere classified
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2017, Amanda Pereira-Salgado, Jennifer A Westwood, Lahiru Russell, Anna Ugalde, Bronwen Ortlepp, John F Seymour, Phyllis Butow, Lawrence Cavedon, Kevin Ong, Sanchia Aranda, Sibilah Breen, Suzanne Kirsa, Andrew Dunlevie, Penelope Schofield
Free to Read? Yes
Use Rights Creative Commons Attribution licence
Persistent URL http://hdl.handle.net/10536/DRO/DU:30108754

Document type: Journal Article
Collections: Centre for Quality and Patient Safety
Open Access Collection
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Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.