SMS Chatbot Support for Gastrointestinal Cancer

Overseen By Lawrence N Shulman, MD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Abramson Cancer Center of the University of Pennsylvania

Must be taking: Capecitabine

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

Duration: 12 weeks

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to assist individuals taking capecitabine, a complex oral chemotherapy drug for gastrointestinal (GI) cancers, in better managing their treatment. The trial employs "Penny," an SMS-based chatbot via the Memora Platform, to guide patients on medication timing and monitor side effects. This approach seeks to improve adherence to the treatment plan and reduce the risk of incorrect dosing, which can lead to serious side effects. Individuals with GI cancer taking capecitabine, either alone or with other treatments like radiation or additional chemotherapy, might be suitable candidates for this study. As an unphased trial, this study provides a unique opportunity to explore innovative methods for enhancing treatment management and patient support.

Will I have to stop taking my current medications?

The trial information does not specify if you need to stop taking your current medications. However, since the trial involves specific chemotherapy regimens, it's best to discuss your current medications with the trial team to ensure there are no interactions.

What prior data suggests that this SMS chatbot intervention is safe for patients with gastrointestinal cancer?

Research has shown that the Penny chatbot, available through the Memora Platform, helps cancer patients manage their medication schedules and side effects. In a small study, patients sent nearly 4,000 text messages about their medications to the chatbot. The system correctly understood about 93% of these messages, indicating its reliability in communicating with patients about their treatment. No reports of negative effects have emerged from using the chatbot. However, it is important to remember that the chatbot is designed to assist and guide, not replace direct medical care. Overall, evidence suggests that the chatbot is safe for helping patients adhere to their treatment plans. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the SMS chatbot intervention, "Penny," because it represents a novel approach to supporting patients with gastrointestinal cancer. Unlike traditional treatments that focus directly on medical intervention, Penny offers continuous, personalized support via text messages, which can help manage symptoms, provide education, and improve patient engagement. This can be particularly beneficial for patients who may feel isolated or need additional guidance outside of clinic visits. By enhancing communication and support through a convenient digital platform, Penny aims to improve overall patient care and quality of life.

What evidence suggests that the SMS chatbot support is effective for gastrointestinal cancer patients?

Research has shown that the Penny SMS chatbot aids patients with gastrointestinal cancer in managing their medication more effectively. A small initial study found that Penny uses surveys and language technology to help patients adhere to their medication schedule. As a result, patients are more likely to take their medication as prescribed, which is crucial for effective treatment. The chatbot also sends reminders and checks in with patients weekly, assisting them in following their complex medication plans. These features aim to reduce the risk of side effects and ensure patients fully benefit from their treatment. Overall, early evidence suggests that Penny can enhance the management of oral chemotherapy for patients. ^{1 3 4 6 7}

Are You a Good Fit for This Trial?

This trial is for patients with gastrointestinal cancers who are taking oral chemotherapy, specifically capecitabine alone or in combination with other treatments like oxaliplatin, temozolomide, radiation therapy, or mitomycin.

Inclusion Criteria

I am over 18 and being treated for GI cancer with specific medications.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive guidance on oral chemotherapy adherence and side effect management via the Penny SMS Text-based chatbot

12 weeks

Remote interactions via SMS

Follow-up

Participants are monitored for safety and effectiveness after treatment

12 months

What Are the Treatments Tested in This Trial?

Interventions

• 'Penny' via Memora Platform

Trial Overview 'Penny' is a chatbot delivered via the Memora Platform designed to help these patients manage their medication schedules and side effects. The study aims to improve adherence to complex oral chemotherapy regimens and better handle toxicity by providing remote guidance and monitoring.

How Is the Trial Designed?

Group I: Penny, a SMS Text-based chatbot intervention Experimental Treatment 1 Intervention

This is a single arm study. All recruited patients will be entered on the Penny SMS Text-based chatbot intervention.

Who Is Running the Clinical Trial?

Abramson Cancer Center of the University of Pennsylvania

Lead Sponsor

Trials

360

Recruited

108,000+

Abramson Cancer Center at Penn Medicine

Lead Sponsor

Trials

425

Recruited

464,000+

Published Research Related to This Trial

A feasibility study involving 60 pancreatic cancer patients showed that an educational chatbot about genetic testing was well-received, with 80% of participants engaging with it and 71% completing surveys.

Patients who opted for genetic testing interacted more with the chatbot, suggesting that providing education through this method may help reduce decisional conflict and encourage testing adoption.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Feasibility of the Genetic Information Assistant Chatbot to Provide Genetic Education and Study Genetic Test Adoption Among Pancreatic Cancer Patients at Johns Hopkins Hospital. Soley, N., Klein, A., Taylor, CO., et al.[2023]

The pilot version of the Rosa chatbot, developed over two years with input from patients and healthcare professionals, aims to assist breast and ovarian cancer patients in understanding genetic BRCA testing, highlighting the importance of user-centered design in health technology.

Despite initial challenges with AI matching user questions to answers, the final version of the chatbot significantly expanded its database and received positive feedback from users regarding its layout and trustworthiness, indicating potential for real-world application in healthcare settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Ask Rosa - The making of a digital genetic conversation tool, a chatbot, about hereditary breast and ovarian cancer. Siglen, E., Vetti, HH., Lunde, ABF., et al.[2022]

A study involving 63 patients (20 using a chatbot and 43 receiving usual care) found that the chatbot significantly reduced emergency department visits and unscheduled hospitalizations for patients undergoing chemotherapy for gynecologic cancers.

Patients using the chatbot had an adjusted incidence rate ratio of 0.27 for ED visits and 0.31 for unscheduled hospitalizations, indicating a strong potential for chatbots to improve patient management and reduce healthcare burdens during cancer treatment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Using a chatbot to reduce emergency department visits and unscheduled hospitalizations among patients with gynecologic malignancies during chemotherapy: A retrospective cohort study. Huang, MY., Weng, CS., Kuo, HL., et al.[2023]

In a study involving 95,166 patients, 64.2% engaged with a clinical chatbot designed to assess hereditary cancer risk, with 89.4% completing the risk assessment, indicating high acceptability and usability of the tool.

The chatbot identified that 25% of users met the criteria for genetic testing for hereditary cancer syndromes, and among those tested, 5.6% had a pathogenic variant, demonstrating its effectiveness in triaging high-risk patients for further evaluation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Hereditary Cancer Risk Using a Genetic Chatbot Before Routine Care Visits. Nazareth, S., Hayward, L., Simmons, E., et al.[2023]

In a study involving 142 women with breast cancer, the artificial conversational agent (chatbot) Vik provided answers that were as satisfying as those given by a group of physicians, with a success rate of 69% compared to 64% for physicians, demonstrating noninferiority.

This research suggests that chatbots like Vik can effectively inform patients about their treatment, potentially reducing the need for in-person consultations for minor health concerns, allowing doctors to focus on patients who require more direct care.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Chatbot Versus Physicians to Provide Information for Patients With Breast Cancer: Blind, Randomized Controlled Noninferiority Trial. Bibault, JE., Chaix, B., Guillemassé, A., et al.[2020]

An automated chatbot (Chats) was found to be a feasible tool for supporting head and neck cancer patients during radiation treatment, with 89% of users finding it easy to use and 61% reporting it helped with symptom self-management.

The study revealed a fair concordance between patient-reported outcomes and clinician-reported outcomes, highlighting that patients often under-reported symptoms like salivary duct inflammation and xerostomia, indicating the chatbot could help bridge this gap in communication.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Automated health chats for symptom management of head and neck cancer patients undergoing radiation therapy. Ma, D., Orner, D., Ghaly, MM., et al.[2022]

Citations

1. pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov/38237102/

Pilot Study of a Mobile Phone Chatbot for Medication ... We conducted a pilot study of PENNY-GI, a mobile phone text messaging-based chatbot that leverages algorithmic surveys and natural language processing.

2. ascopubs.org ascopubs.org/doi/abs/10.1200/OP.23.00365

Pilot Study of a Mobile Phone Chatbot for Medication ... We conducted a pilot study of PENNY-GI, a mobile phone text messaging–based chatbot that leverages algorithmic surveys and natural language processing.

3. withpower.com withpower.com/trial/phase-gastrointestinal-neoplasms-7-2021-c37f9

SMS Chatbot Support for Gastrointestinal Cancer The Penny treatment is unique because it uses a chatbot on the Memora Platform to provide support for gastrointestinal cancer patients, offering a dynamic ...

4. researchgate.net researchgate.net/publication/377497728_Pilot_Study_of_a_Mobile_Phone_Chatbot_for_Medication_Adherence_and_Toxicity_Management_Among_Patients_With_GI_Cancers_on_Capecitabine

Pilot Study of a Mobile Phone Chatbot for Medication ... METHODS We conducted a pilot study of PENNY-GI, a mobile phone text messaging–based chatbot that leverages algorithmic surveys and natural language processing ...

5. ascopubs.org ascopubs.org/doi/10.1200/JCO.2022.40.28_suppl.424

An augmented intelligence mobile phone chatbot for ... Penny provides patients with medication reminders tailored to their prescribed doses and schedules, sends weekly check-in messages, manages low- ...

6. healthcareitnews.com healthcareitnews.com/news/penn-medicine-uses-ai-chatbot-penny-improve-cancer-care

Penn Medicine uses AI chatbot 'Penny' to improve cancer ... Nearly 4000 medication-related text messages were exchanged between patients and Penny – and approximately 93% were accurately interpreted.

7. ovid.com ovid.com/journals/jcopr/fulltext/10.1200/op.23.00365~pilot-study-of-a-mobile-phone-chatbot-for-medication

Pilot Study of a Mobile Phone Chatbot for Medication Adherence ... We conducted a pilot study of PENNY-GI, a mobile phone text messaging–based chatbot that leverages algorithmic surveys and natural language processing to ...