Impact of mobile applications on adherence to cancer treatment: a systematic review and meta-analysis protocol

Abstract

IntroductionThe number of patients taking oral chemotherapy is increasing around the world. It is essential to maximise the adherence to oral chemotherapy to improve the overall survival and life expectancy of the patients. In this systematic review and meta-analysis, we aim to evaluate the effectiveness of mobile applications in improving the adherence to oral chemotherapy and adjuvant hormonal therapy in cancer survivors.Methods and analysisMEDLINE, Embase, LILACS, clinicaltrials.gov, Scopus and the Cochrane Central Register of Controlled Trials will be searched for randomised or quasi-experimental studies published between January 2009 and July 2019. This systematic review and meta-analysis will include studies investigating the use of mobile applications by cancer survivors to aid adherence to oral chemotherapy and adjuvant hormonal therapy. Patient education, reminder tools, calendars, pillboxes and electronic reminders will not be evaluated. The primary outcome will be the improvement in adherence to anticancer drugs. The secondary outcomes will be an improvement in the overall survival and life expectancy, improved quality of life and control of cancer-related symptoms. Three independent reviewers will select the studies and extract data from the original publications. The risk-of-bias will be assessed using the Cochrane risk-of-bias tool. Data synthesis will be performed using the Review Manager software (RevMan V.5.2.3). To assess heterogeneity, we will compute the I2 statistics. Additionally, a quantitative synthesis will be performed if the included studies are sufficiently homogenous.Ethics and disseminationThis study will be a review of the published data, and thus, ethical approval is not required. Findings of this systematic review will be published in a peer-reviewed journal.PROSPERO registration numberCRD42018102172.

Use of the ONCO-TreC electronic diary compared with a standard paper diary to improve adherence to oral cancer therapy in patients with solid and haematological tumours: protocol for a randomised controlled trial

“…However, despite the numerous studies published on this issue, there is still a clear need to further promote the validation of technological, organisational and m-health platforms (eg, APP) to support patients' self-management, which is a key factor in sustaining proper treatment adherence. 22 The present multicentre randomised study represents a unique contribution in this area in that it will be the first to compare the efficacy of an electronic diary with that of standard clinical practice. Nowadays, the majority of patients with cancer, even the elderly, use smart phones or tablets on a regular basis.…”

“…However, despite the numerous studies published on this issue, there is still a clear need to further promote the validation of technological, organisational and m-health platforms (eg, APP) to support patients’ self-management, which is a key factor in sustaining proper treatment adherence. 22 …”

Adherence to oral chemotherapy: Evidence from a randomised clinical trial

“…It is known that medication adherence is influenced by various factors, which can depend on the patient himself, the disease state, the medication and the medical staff (Lima et al, 2018;Spoelstra et al, 2016). Indeed, previous studies have been conducted in order to determine preventive strategies and improve the percentage of medication adherence among patients undergoing oral therapy for prolonged periods (Krikorian et al, 2019;Medeiros et al, 2019;Ross et al, 2019;Spoelstra et al, 2016). In order to detect adherence with an objective measure, our study performed repeated and regular determinations of plasma drug levels during the visits.…”

Medication Adherence in Cancer Patients: A Comprehensive Review

“…However, most of these studies were plagued with bias, and therefore, medication adherence continues to be a significant hurdle in the management of cancer. Some factors that may affect medication adherence include the cost of the treatment, the complexity of the therapeutic regimens, drug-food interactions, drug-drug interactions, adverse effects, and patient-related factors such as forgetfulness and carelessness [ 20 ]. Recently, telemedicine, mobile applications, and electronic diaries such as a remote monitoring system to optimize the home management of oral anticancer therapies (ONCO-TreC) were suggested to improve the monitoring of patients regarding medication adherence [ 21 ].…”