Title : Using SMS technology to improve quality of life and symptom management in the breast cancer patient population: A feasibility study
Abstract:
Significance: Cancer patients experience a wide range of negative side effects/symptoms from chemotherapy and radiation including pain, dehydration, nausea/vomiting, and diarrhea/constipation. Symptoms are distressing and decrease the overall quality of life and increase unnecessary hospitalizations. Symptom management and quality of life may be improved by using Short Message System (SMS) texting in cardiac and diabetic patient populations. The technology may also decrease costs for unnecessary emergency department (ED) visits by breast cancer patients.
Purpose: The purpose of this study was to determine if an SMS texting service can improve quality of life by improving symptom management. A secondary purpose was to evaluate if texting decreases emergency visits by breast cancer patients.
Interventions: This IRB-approved, consented study implemented an SMS texting program for breast cancer patients. Participants received two texts per day during their chemotherapy treatment period (6 months), one text being informational regarding symptom management and the second was one of encouragement and inspiration. Participants were called bi-weekly to complete the Distress Thermometer for Patients (NCCN). ED visits and/or hospital admission rates for the sample were collected. An exit interview measured satisfaction of the program in quantitative measures and theme analysis for qualitative measures. Twenty patients participated in this study, with 13 included in the data analysis.
Evaluation: Mean scores of the Distress Thermometer results were 3.6. The overall satisfaction of the SMS program was 8.89. Forty percent of participants had a change in treatment due to their symptom management text. The most common domain of symptoms reported was physical in nature. Ten percent of the participants visited the emergency department during the study. Almost all participants felt supported and cared for due to weekly calls by the investigators.
Discussion: Due to the small sample size, statistical significance was not met, and generalization and validity is challenged. Patients with human connection feel supported and cared for during illness. An interactive SMS texting program may be beneficial to further help symptom management and engagement with patients. SMS texting is feasible and easily integrated into the care of breast cancer patients.