Improving treatment adherence in patients with cancer in low and middle-income countries, through digital health self-care interventions.

Abstract

114 Background: The WHO notes that adherence to treatment for people living with chronic conditions, including cancer is of global concern. This poor adherence is brought about in low- and middle-income countries like Nigeria, by patient factors such as poor health literacy, overshadowing religious beliefs, and forgetfulness, as well as systemic factors like fragmented patient care due to physician burnout. The aim of this study was to evaluate the effectiveness of digital self-care interventions via CompleteHealth in improving treatment adherence in people living with cancer. Methods: This was a retrospective study done on 63 patients on treatment for metastatic castrate-resistant prostate cancer, enrolled on mDoc’s digital CompleteHealth platform between January to December 2022. Each patient was assigned a virtual health coach who provided self-care support, monitored their health metrics, encouraged regular physical activity, and maintained normal body weight. Synchronous and asynchronous digital nudges were provided via the multiple channels of the digital CompleteHealth platform such as the web app, SMS, and phone calls. The patients also had access to virtual fitness, nutrition, and emotional wellness coaches as required. Results: 56/63 patients (88%) completed their full course of 6 months of treatment. The adherence was at 78.4%, which represents the average percentage of members who refilled medication as at when due, allowing for 30 days or less between fillings. Allowing for 90 days in between fillings, adherence was at 90.5%. Conclusions: The use of digital health interventions via virtual health coaching for self-care support has been demonstrated through CompleteHealth to improve treatment adherence in patients living with cancer significantly. There is therefore a place to scale up the use of digital health coaching to further improve this statistic, as it is likely to impact treatment outcomes positively.