TITLE:
Effectiveness of Short Message Service Support on Adherence to Chemotherapy Treatment among Patients Attending Cancer Treatment Facilities in Kenya
AUTHORS:
Nebert Kiguhe Mchidi, John P. Oyore, Gordon Ogweno
KEYWORDS:
Adherence, Cancer, Symptom Distress, Quality of Life, Medication Posses-sion Ratio, Short Message Service, Survivorship
JOURNAL NAME:
Open Journal of Nursing,
Vol.14 No.3,
March
29,
2024
ABSTRACT: Introduction: Cancer is a chronic debilitating disease that unnerves patients,
communities, and nations. At some point in cancer patient’s disease experience,
chemotherapy is used, and the patient is expected to adhere to treatment to
improve survival and quality of life. Methods: This multisite Cluster
Randomized Trial (CRT) evaluated the effectiveness of mobile phone Short
Message Service (SMS) support on the adherence to treatment schedules among
adult cancer patients in Kenya. Data was collected using questionnaires.
Ethical approvals were obtained from relevant Ethical Review Boards (ERBs). Results: The mean adherence was 83%. There was a significant difference between
treatment arms in relation to the adherence. The intervention arm had a higher
mean adherence difference, M = 3.913, 95% CI 2.632-5.193, t (402) = 6.006, p ≤ 0.001),
with Cohen’s d = 0.60. Although not significant, (χ2dd = 0.151, df = 1, p = 2.064), more women were
perfect adheres than males. Perfect adherers were satisfied with SMS support (χ2dd = 7.620, df = 1, p = 0.06),
were in the intervention arm (χ2dd
= 22.942, df = 1, p ≤ 0.001),
and had trust in the care provider (χ2dd
= 10.591 p ≤ 0.001).
SMS support was not significant in the multivariate analysis but had an
estimated effect size of 0.958 (z = 1.424, p = 0.154, CI = 0.242-3.781), indicating that mean adherence was slightly better in the presence of
the intervention. Conclusions: SMS-support
intervention has demonstrated superiority in influencing adherence. Further,
health system-related factors have a significant influence on the adherence to
chemotherapy treatment. Interventions to re-design health systems that
are responsive to unmet care needs of cancer patients must be explored.