Study: Text messages are ineffective reminders to maintain AI regimens

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Text messages were not effective in reminding breast cancer patients to maintain their aromatase inhibitor regimens, a study conducted by SWOG shows.

SWOG Cancer Research Network Vice Chair Dawn Hershman, director of the Breast Cancer Program at NewYork-Presbyterian and Columbia University Irving Medical Center’s Herbert Irving Comprehensive Cancer Center, led the study, which was published in the Journal of Clinical Oncology.

The study is the first large, long-term, randomized trial to test any intervention aimed at directly improving AI adherence. Hershman and her team enrolled 724 post-menopausal women with early-stage breast cancer into the study from 40 SWOG sites across the United States. Every woman had been taking AIs for at least a month, and would continue to take the pills at least 36 months under their doctors’ orders.

Of the women enrolled, 348 received brief, twice-weekly text messages reminding them to take their medication or reminding them of the benefits of taking their medication. Another 354 did not receive the texts. Patients and physicians both reported on drug adherence—and women took routine urine tests to screen for AI biomarkers. After 36 months, there was no difference between the two groups. The percentage of women who remained AI adherent was 55%—the same number for both groups, no matter how adherence was measured.

Hershman, who presented preliminary results of her study at the 2019 ASCO annual meeting, said the take-home message is not that text messages are ineffective tools in the fight for cancer drug adherence.

“Persuading patients to take AIs, or any long-term cancer drug, will likely require a more personalized approach, one that includes many interventions and supportive efforts to provide relief from symptoms and also provide encouragement and support for patients,” Hershman said in a statement. “Texts alone don’t do the trick.”

Hershman’s study was funded by NCI grant award CA189974 and in part by the Conquer Cancer Foundation and the Breast Cancer Research Foundation.

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