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Daily text message assessments of 6‐mercaptopurine adherence and its proximal contexts in adolescents and young adults with leukemia: A pilot study
Author(s) -
Psihogios Alexandra M.,
Li Yimei,
Ahmed Annisa,
Huang Jing,
Kersun Leslie S.,
Schwartz Lisa A.,
Barakat Lamia P.
Publication year - 2021
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.28767
Subject(s) - medicine , pill , psychological intervention , mood , family medicine , affect (linguistics) , text message , intervention (counseling) , young adult , gerontology , clinical psychology , psychiatry , nursing , computer network , linguistics , philosophy , computer science
Background This pilot study explored the feasibility and acceptability of implementing text‐based assessments of oral chemotherapy adherence in adolescents and young adults (AYA) with leukemia. Methods AYA prescribed maintenance 6‐mercaptopurine (6MP) received daily text message surveys and utilized an electronic pill bottle for 28 days. Text surveys assessed 6MP adherence and contextual associates (eg, mood). Feasibility was defined by recruitment/retention rates, survey completion rates, cost, and technical issues. After the 28‐day period, AYA completed an acceptability survey. Secondary analyses compared text survey and electronic pill bottle adherence rates, and explored the daily associations between contextual factors and 6MP nonadherence. Results Eighteen AYA enrolled ( M age = 18, range 15‐22) and completed study procedures (100% recruitment and retention rates). Adherence survey completion rates were high ( M = 88.9%), the technology cost was $204.00, and there were few technical issues. AYA reported high satisfaction with the surveys and perceived them as a helpful medication reminder. While not significantly correlated, survey and electronic pill bottle adherence data converged on the majority of days (>90%). Exploratory analyses showed that AYA were more likely to miss a dose of 6MP on weekends (OR = 2.33, P = .048) and on days when their adherence motivation (OR = 0.28, P = .047) and negative affect (OR = 3.92, P = .02) worsened from their own typical functioning. Conclusions For AYA with leukemia, daily text‐based surveys are a feasible and acceptable method for delivering medication adherence assessments, and may operate as a short‐term intervention. To develop personalized mobile health interventions, findings also highlighted the need to study time‐varying predictors of 6MP nonadherence.