Randomized trial of pharmacist-led advanced messaging intervention to enhance medication adherence in patients with Non-Small Cell Lung Cancer (NSCLC) (Preprint)

BACKGROUND Medication adherence is crucial for improving clinical outcomes in the treatment of cancer patients, and text messaging has been implemented for the promotion of medication adherence. Compared with the conventional 2G text-based message, 5G message is an advanced messaging service that adds large-scale information including voice and video. OBJECTIVE In this study, we conducted a clinical pharmacist-led prospective randomized controlled trial to evaluate the effect of tailored voice and video-contained 5G messaging on medication adherence and hematotoxicity in patients with Non-Small Cell Lung Cancer (NSCLC) with chemotherapy who need regular folic acid/vitamin B12 supplement. METHODS A total of 154 patients were randomized to receive 5G messages (n=74) or standard care (n=80) between January and May 2021. Medication adherence was assessed using the eight-item Morisky Medication Adherence Scale at baseline, 1 month and 3 months after discharge. The effect of the voice and video-contained 5G messaging intervention for adherence outcomes were estimated. Moreover, the chemotherapy-related non-hematologic toxicity, as well as the serum levels of folate and vitamin B12 were measured. RESULTS We found that the odds of adherence in 5G message-intervened group were significantly higher at 1-month (OR=2.67, 95% CI: 1.02-7.71, P = 0.034) and 3-month (OR=2.36, 95% CI: 1.00-5.23, P =0.049) timepoints. In the aspect of hematologic toxicities, the incidence of leukopenia in the intervention group was lower than that in the control group. Although there were no differences in hematologic/non-hematologic toxicities and median EQ-5D-3L index value between the patients in 5G message-intervened and control groups, the serum folate levels in patients of 5G message-intervened group were higher than those of control group at the 1-month timepoint. CONCLUSIONS In summary, we conclude that 5G messaging improves short-term medication adherence and alleviates chemotherapy-induced hematotoxicity. CLINICALTRIAL The study was approved by the Clinical Trials Ethics Committee of Shanghai Tenth People’s Hospital (SHSY-IEC-4.1/21-248/01).