Abstract B119: Effect of a smart pill bottle and text messaging-based intervention on medication adherence and side effect management in African American women with breast cancer new to endocrine therapy
Authors: Wen Kuang-Yi , Miller Suzanne , Padmanabhan Aruna , Smith Rita , Lapitan Emmanuel , Goldstein Lori 
Published: January 2023

Abstract
Background For women with hormone receptor-positive breast cancer (BCa), approximately 75-80% of all BCa cases, long-term use of endocrine therapy has been demonstrated to improve disease free survival. However, data reported that non-adherence rates range from 28% to 59%, and African American (AA) women had lower odds of being adherent to endocrine therapy than other racial/ethnic groups, suggesting that medication adherence might be an important level for targeting racial disparities in AA BCa outcomes. Emerging adherence-promoting interventions using technologies to provide at-home medication management support, however, few studies have formally assessed their effects in minority groups. The objective of this study was to evaluate the impact of an interactive text messaging (TXT) intervention and a smart pill bottle (SPB) on adherence to endocrine therapy and symptom management among AA women with early stage BCa. Method This prospective and random assignment study recruited 48 AA women with early stage ER+ or PR+ BCa who completed active treatments and were new to endocrine therapy. Participants were randomized to 1:1: between the txt2adhere and control groups. The txt2adhere group received interactive text messages three times a week, that were culturally tailored addressing barriers on the cognitive, affective interpersonal and symptom levels. The intervention group also received a SPB with light and chimes reminders. The control group received an identical SPB with all alerts deactivated. Patient adherence was calculated by % days adherent over the study time. The study was 3 months and patient-reported outcomes were collected at 1-month, 2-month and 3-month. A post-intervention interview was conducted to understand participant’s satisfaction and feedback. Results Forty-eight women were enrolled with 22 randomized in the txt2adhere group and 26 in the control group; 4 patients in the txt2adhere and 3 in the control were lost of follow up. Participants are in average 57 years old; 71% had an annual household income of $45K and lower; and 67% had a stage I BCa. Overall, the txt2adhere group has a 91% adherence rate at the end of 3-month study compared with 89% in the control group. Post-intervention interviews revealed the utility and feasible of the intervention, areas for TXT content improvement in symptom management such as joint pain and hot flashes were also identified. Conclusion In this study, a culturally-sensitive TXT intervention equipped with a SPB were associated with increased medication adherence, which need to be tested in a fully powered study. This pilot provides preliminary data on the feasibility of adherence technology used in an underserved AA population.
Citation Format: Kuang-Yi Wen, Suzanne Miller, Aruna Padmanabhan, Rita Smith, Emmanuel Lapitan, Lori Goldstein. Effect of a smart pill bottle and text messaging-based intervention on medication adherence and side effect management in African American women with breast cancer new to endocrine therapy [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr B119.