A Health Belief Messaging Framework and a Randomized Controlled Trial of an SMS-Based Intervention for Cancer Patient Outcomes

Cancer is on the rise, and the effectiveness of oral anticancer agent (OA) treatment depends heavily on adherence to the prescribed regimen. Adherence, however, is a significant problem with 42% of patients missing OA doses due to poor memory recall, lack of knowledge, incompatible beliefs, and depressive symptoms. Short Message Service (SMS) messaging may provide a feasible, low-cost approach to promote adherence and lead to improved patient outcomes when compared to other strategies that have had disappointing results. Through our Health Belief Messaging Framework, we propose that SMS message development may be informed by adherence antecedents, namely Perceived Benefits, Perceived Barriers, and Cues to Action. Through a 2-group, 80-patient, randomized controlled trial of a tailored, daily SMS intervention for 21 days, an improved adherence trend, and a statistically significant effect on the number of symptoms and physical function was observed, patient satisfaction with the SMS messaging was also reported.