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Patient-Centered Innovations, Education and Technology for Cancer Care, Cancer Survivorship and Cancer Research
JMIR Cancer (JC) is a Pubmed-indexed, peer-reviewed journal with a focus on education, innovation and technology in cancer care, cancer survivorship and cancer research, as well as in participatory and patient-centred approaches. A sister journal of the Journal of Medical Internet Research (JMIR), a leading eHealth journal (Impact Factor 2016: 5.175), the scope of JC is broader and includes non-Internet approaches to improve cancer care and cancer research.
We invite submission of original research, viewpoints, reviews, tutorials, case studies, and non-conventional articles (e.g. open patient education material and software resources that are not yet evaluated but free for others to use/implement).
In our "Patients' Corner", we invite patients and survivors to submit short essays and viewpoints on all aspects of cancer, but in particular suggestions on how to improve the health care system, and suggestions for new technologies, applications and approaches (no article processing fees).
JC is open access and all articles are published under a Creative Commons Attribution license. JC has been accepted for indexing in PubMed Central and Pubmed.
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Background: A fundamental limitation in the field of medication adherence is measurement of real-time medication-taking behavior that can be used to identify specific barriers and individualize interv...
Background: A fundamental limitation in the field of medication adherence is measurement of real-time medication-taking behavior that can be used to identify specific barriers and individualize intervention. Advanced Sensored Medication Devices (SMDs) can capture and transmit real-time information when a scheduled device opening is missed. Many recently approved medications in multiple myeloma (MM) are oral and taken on complex and irregular schedules. These new oral agents have resulted in improved survival, but adherence is a concern. Objective: To: 1) identify patient-reported barriers to medication adherence; and 2) understand patients’ attitudes towards the use of SMDs in a group of patients from lower socioeconomic backgrounds in treatment for MM. Methods: An in-person, semi-structured, qualitative interview was conducted with a convenience sample of patients being treated for MM. Patients were recruited from within an urban, minority-serving, academic medical center that had an established cancer center. Using a standardized interview guide, patients were asked about comfort with technology, experience with taking daily medications before being diagnosed with MM, and experiences with missing doses of oral anticancer medications and contributing factors. This transitioned into showing patients two different pill bottles with sensor-technology – Medication Event Monitoring System® and the SMRxT® bottle. After receiving information on the transmission ability of the bottles, patients were asked to discuss their reactions and concerns with the idea of using such a device. The interviews were audio-recorded and transcribed. Interviews were independently coded by two members of the team with a third providing guidance. Results: Twenty patients participated having a mean age of 56 years (range=29-71 years) and 70% were African American. Over half of the patients described themselves as having some degree of comfort with technology referring to the internet, text messaging, and cellphone applications. Twelve patients (60%) reported that their first experience taking daily medications was related to the MM treatments. The average number of medications reported per patient was 13 medications (range = 3 to 24). Fourteen (70%) reported missed doses for a range of reasons such as fatigue, feeling ill, a busy schedule, forgetting, or side effects. Interest in using a SMD ranged from great interest to complete lack of interest. Examples of concerns related to the SMDs included privacy issues, potential added cost, and the size of the bottle (i.e. too large). Despite the concerns twelve (60%) patients expressed interest in trying a bottle in the future. Conclusions: Despite the small sample, patients reported numerous factors that contributed to missed doses of oral anti-cancer therapy. Many of these appear to be potentially mutable if uncovered and addressed. SMDs may allow for real-time capture of this data. While patients expressed concerns with SMDs, most remained willing to use one. A feasibility trial with SMDs is planned.