Lessons learned in the development and evaluation of RxCoach™, an mHealth app to increase tobacco cessation medication adherence.
Judith S Gordon, Julie S Armin, James K Cunningham and 3 others
PMID 27839891WHAT IT FOUND
Smokers taking varenicline who used RxCoach reported taking it 28 of 30 days and liked the app, but only seven enrolled and four returned at three months, so this shows feasibility, not effectiveness.
Key findings
01Five feasibility participants completed the 1-month survey; four reported current varenicline use, averaging 28 of 30 days, and all reported never forgetting a dose.
02At 3 months, four participants completed the survey; one reported continued varenicline use, and the mean days of use over 90 days was 63.7.
03Participants rated the app easy to use, helpful for taking varenicline, and likely to recommend it; one participant said it reminded them to take the pill.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The feasibility test enrolled only 7 participants; 5 completed the 1-month survey and 4 completed the 3-month survey. The paper describes a feasibility study, not a comparison trial, so reported adherence and satisfaction cannot be compared with usual care. Adherence was self-reported; the paper states app-reported side-effect checklist results were not reported. Recruitment was difficult: 29 of 50 screened were excluded, and only 7 of 21 eligible downloaded the app. The feasibility sample was all female, White, college-educated, and iPhone-only, so it may not apply to other groups. Attrition may have been influenced by little study contact, side effects, and technical issues.
Declared interests
The authors report no conflicts of interest. The supplied publication types note NIH extramural research support.
The easy way to misread this
Do not conclude that RxCoach increases varenicline adherence or smoking cessation. The study had only 7 enrolled participants, used self-reported adherence, had no control group, and lost participants before follow-up.