Use of Text Messaging (SMS) for the Management of Side Effects in Cancer Patients Undergoing Chemotherapy Treatment: a Randomized Controlled Trial

Cancer patients are often not sufficiently oriented to manage side effects at home. Sending text messages with self-care guidelines aimed managing side effects is the main objective of this randomized controlled trial. Patients who started outpatient chemotherapy treatment between March and December 2017 at a hospital in southern Brazil were invited to participate in this study and were allocated to the intervention or control group (ratio 1: 1). Each patient in the intervention group received a daily SMS (short message service) with some guidance on management or prevention of side effects. All text messages were sent to the intervention group patients in an automated and tailored way by our app called cHEmotHErApp. Side effects experienced by patients were verified using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core-30 (EORTC QLQ-C30). Results showed intervention group patients experienced fewer side effects compared to the control group in cycle 1 (p < 0.05), in general. In addition, intervention group experienced less nausea in relation to the control group, in the cycle 1 and cycle 2 (p < 0.05). This study indicate text messaging may be a tool for supporting side effect management in patients receiving chemotherapy. This study was enrolled in ClinicalTrials.gov with the identification number NCT03087422. This research was performed in accordance with the Declaration of Helsinki.

[1]  J. Horton,et al.  CLINICAL ONCOLOGY , 1978, The Ulster Medical Journal.

[2]  Crispin R Dass,et al.  Doxorubicin: an update on anticancer molecular action, toxicity and novel drug delivery systems , 2013, The Journal of pharmacy and pharmacology.

[3]  C. von Wagner,et al.  Text-message Reminders in Colorectal Cancer Screening (TRICCS): a randomised controlled trial , 2017, British Journal of Cancer.

[4]  A. Langius-Eklöf,et al.  Effects of an interactive mHealth innovation for early detection of patient-reported symptom distress with focus on participatory care: protocol for a study based on prospective, randomised, controlled trials in patients with prostate and breast cancer , 2017, BMC Cancer.

[5]  Stephen T. Sonis,et al.  The Economic Burden of Toxicities Associated with Cancer Treatment: Review of the Literature and Analysis of Nausea and Vomiting, Diarrhoea, Oral Mucositis and Fatigue , 2013, PharmacoEconomics.

[6]  D. Wald,et al.  One-way versus two-way text messaging on improving medication adherence: meta-analysis of randomized trials. , 2015, The American journal of medicine.

[7]  I. Olver Update on anti‐emetics for chemotherapy‐induced emesis , 2005, Internal medicine journal.

[8]  P. Francis,et al.  Impact of a novel nurse-led prechemotherapy education intervention (ChemoEd) on patient distress, symptom burden, and treatment-related information and support needs: results from a randomised, controlled trial. , 2012, Annals of oncology : official journal of the European Society for Medical Oncology.

[9]  M. Cucciniello,et al.  The Performance of mHealth in Cancer Supportive Care: A Research Agenda , 2015, Journal of medical Internet research.

[10]  Constantinos K. Coursaris,et al.  A Health Belief Messaging Framework and a Randomized Controlled Trial of an SMS-Based Intervention for Cancer Patient Outcomes , 2015, 2015 48th Hawaii International Conference on System Sciences.

[11]  P. Mazzola,et al.  Nausea, vomiting and quality of life of patients with cancer undergoing antineoplastic treatment: an evaluation by pharmacists , 2015, International Journal of Pharmacy Practice.

[12]  C. Meade,et al.  Efficacy and costs of two forms of stress management training for cancer patients undergoing chemotherapy. , 2002, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[13]  M. Wolf,et al.  Comparative effectiveness of a multifaceted intervention to improve adherence to annual colorectal cancer screening in community health centers: a randomized clinical trial. , 2014, JAMA internal medicine.

[14]  Brianna S Fjeldsoe,et al.  Preventive Health Behavior Change Text Message Interventions: A Meta-analysis. , 2017, American journal of preventive medicine.

[15]  L. Vitetta,et al.  New Insights into Potential Prevention and Management Options for Chemotherapy-Induced Peripheral Neuropathy , 2016, Asia-Pacific journal of oncology nursing.

[16]  J. Jardim,et al.  Reproducibility of the Brazilian Portuguese version of the European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire used in conjunction with its lung cancer-specific module. , 2010, Jornal brasileiro de pneumologia : publicacao oficial da Sociedade Brasileira de Pneumologia e Tisilogia.

[17]  A. Schreier,et al.  The effect of education in managing side effects in women receiving chemotherapy for treatment of breast cancer. , 2004, Oncology nursing forum.

[18]  H P Soyer,et al.  The HealthyTexts study: a randomized controlled trial to improve skin cancer prevention behaviors among young people. , 2013, Contemporary clinical trials.

[19]  H. Cole-Lewis,et al.  Text messaging as a tool for behavior change in disease prevention and management. , 2010, Epidemiologic reviews.

[20]  K. Yap,et al.  Feasibility and acceptance of a pharmacist-run tele-oncology service for chemotherapy-induced nausea and vomiting in ambulatory cancer patients. , 2013, Telemedicine journal and e-health : the official journal of the American Telemedicine Association.

[21]  Joseph D Tariman,et al.  Self-care strategies to cope with taste changes after chemotherapy. , 2009, Oncology nursing forum.

[22]  C. Kuziemsky,et al.  Managing symptoms during cancer treatments: evaluating the implementation of evidence-informed remote support protocols , 2012, Implementation Science.

[23]  Penelope Schofield,et al.  The Patient Remote Intervention and Symptom Management System (PRISMS) – a Telehealth- mediated intervention enabling real-time monitoring of chemotherapy side-effects in patients with haematological malignancies: study protocol for a randomised controlled trial , 2015, Trials.

[24]  Amanda K. Hall,et al.  Mobile text messaging for health: a systematic review of reviews. , 2015, Annual review of public health.

[25]  A. McCarthy,et al.  The Effect of a Standardized Ginger Extract on Chemotherapy-Induced Nausea-Related Quality of Life in Patients Undergoing Moderately or Highly Emetogenic Chemotherapy: A Double Blind, Randomized, Placebo Controlled Trial , 2017, Nutrients.

[26]  A. Molassiotis,et al.  Understanding the concept of chemotherapy-related nausea: the patient experience. , 2008, European journal of cancer care.

[27]  Josip Car,et al.  Mobile phone messaging telemedicine for facilitating self management of long-term illnesses , 2008 .

[28]  Eunyoung Kang,et al.  Effect of short message service as a reminder on breast self-examination in breast cancer patients: a randomized controlled trial* , 2015, Journal of telemedicine and telecare.

[29]  G. Storme,et al.  The effect of timing of the provision of information on anxiety and satisfaction of cancer patients receiving radiotherapy. , 2009, Journal of cancer education : the official journal of the American Association for Cancer Education.

[30]  S. Gunnarsdottir,et al.  Effects of web-based interventions on cancer patients’ symptoms: review of randomized trials , 2018, Supportive Care in Cancer.

[31]  David Cella,et al.  Symptoms and treatment burden associated with cancer treatment: results from a cross-sectional national survey in the U.S. , 2008, Supportive Care in Cancer.

[32]  J. R. Jardim,et al.  Reprodutibilidade da versão em português do Brasil do European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire em conjunto com seu módulo específico para câncer de pulmão , 2010 .

[33]  Diane C. Thompson,et al.  The validity of self-reported smoking: a review and meta-analysis. , 1994, American journal of public health.

[34]  P. Viens,et al.  Discordance between physicians' estimations and breast cancer patients' self-assessment of side-effects of chemotherapy: an issue for quality of care. , 1997, British Journal of Cancer.

[35]  S. Chambers,et al.  Effective, clinically feasible and sustainable: Key design features of psycho-educational and supportive care interventions to promote individualised self-management in cancer care , 2015, Acta oncologica.

[36]  H. Wildiers,et al.  Immediate versus delayed self-reporting of symptoms and side effects during chemotherapy: does timing matter? , 2011, European journal of oncology nursing : the official journal of European Oncology Nursing Society.

[37]  H. Allan,et al.  The social construction of cancer chemotherapy toxicity: the case of Taiwan. , 2013, Cancer Nursing.

[38]  V. Hantikainen,et al.  Prevalence of symptoms, with a focus on fatigue, and changes of symptoms over three months in outpatients receiving cancer chemotherapy. , 2011, Swiss medical weekly.

[39]  J. Ostroff,et al.  Rapid Scaling Up of Telehealth Treatment for Tobacco-Dependent Cancer Patients During the COVID-19 Outbreak in New York City. , 2020, Telemedicine journal and e-health : the official journal of the American Telemedicine Association.

[40]  H. Chan,et al.  Side effects of chemotherapy among cancer patients in a Malaysian General Hospital: experiences, perceptions and informational needs from clinical pharmacists. , 2014, Asian Pacific journal of cancer prevention : APJCP.

[41]  Monika Janda,et al.  Can skin cancer prevention and early detection be improved via mobile phone text messaging? A randomised, attention control trial. , 2015, Preventive medicine.

[42]  E. Friedman,et al.  Text-message reminders increase uptake of routine breast screening appointments: a randomised controlled trial in a hard-to-reach population , 2015, British Journal of Cancer.

[43]  S. Iliffe,et al.  Bmc Medical Research Methodology Open Access the Hawthorne Effect: a Randomised, Controlled Trial , 2022 .

[44]  Karina dos Santos Machado,et al.  Text Messaging (SMS) Helping Cancer Care in Patients Undergoing Chemotherapy Treatment: a Pilot Study , 2017, Journal of Medical Systems.

[45]  C. Gross,et al.  Bidirectional Text Messaging to Monitor Endocrine Therapy Adherence and Patient-Reported Outcomes in Breast Cancer. , 2017, JCO clinical cancer informatics.

[46]  N. Kearney,et al.  Evaluation of a mobile phone-based, advanced symptom management system (ASyMS©) in the management of chemotherapy-related toxicity , 2009, Supportive Care in Cancer.

[47]  Deb Feldman-Stewart,et al.  Information needs of early-stage prostate cancer patients: a comparison of nine countries. , 2010, Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology.