A texting system can aid the monitoring of adherence to endocrine therapy and identify adverse events (AEs) among patients with breast cancer, according to a study published in Clinical Cancer Informatics.1

The standard of care for hormone receptor (HR)–positive breast cancer is endocrine therapy for 5 to 10 years, yet up to 40% of women discontinue therapy before 5 years. The reasons for this nonadherence is unknown.

For this study, researchers developed a strategy to monitor adherence and AEs in real-time using bidirectional texting via BETA-Text.

Continue Reading

The study enrolled 100 patients with stage I to III HR-positive breast cancer, of whom 89 completed the study. Reasons for not enrolling in the study included lack of interest or competence with text messaging, not wanting a reminder of breast cancer diagnosis, privacy concerns, and other unspecified reasons.

BETA-Text sent 3 types of system-generated texts: daily medication reminders, weekly AE questions, and monthly texts about barriers to adherence. Text responses could generate alerts to the care team if the patient missed doses or experienced a severe AE. Patients who reported AEs via text messaging received an educational message in reply with information to help manage the AE.

Study participants communicated by text messaging for 3 months, and received a mean of 21 texts per week. The response rate to daily text messages was 86.1%. Text messages resulted in 189 alerts about missed doses of endocrine therapy or severe AEs that led to a nurse-initiated telephone call.

The number of office visits (114 vs 101; P = .31) and patient-initiated telephone calls (32 vs 38; P = .82) was similar between study participants and historical controls.

Patients reported that BETA-Text was easy to use and 69% reported that they would like to continue after the study. The majority of patients (73%) stated that it helped them take their medication “very much” or “quite a lot.” 

RELATED: Overall Body Fat Loss Decreases Biomarkers for Breast Cancer Risk

These results suggest that “BETA-Text represents not only an adherence-enhancement tool that can be tested in randomized clinical trials, but also a novel approach to patient engagement and patient-provider communication,” wrote the authors.


  1. Mougalian SS, Epstein LN, Jhaveri AP, et al. Bidirectional text messaging to monitor endocrine therapy adherence and patient-reported outcomes in breast cancer. Clin Cancer Inform. 2017 May 23. doi: 10.1200/CCI.17.00015 [Epub ahead of print]