Digital intervention for medication adherence and symptom management, the SAFE for gastric cancer patients taking oral anticancer medication: A pilot feasibility study

Purpose Patients taking oral anticancer medications need to manage their medication adherence and symptoms. This study evaluated the feasibility of the Smart Adherence program For Enhancing self-care for oral anticancer medication (SAFE), a digital nursing intervention for gastric cancer patients receiving oral anticancer medication. Methods A one-group pretest–posttest pilot study was conducted, including 30 gastric cancer patients. Participants used the SAFE for 3 weeks to log medication intake and monitor symptoms with automated management guidance. Primary outcomes included feasibility, user satisfaction, and medication adherence. Secondary outcomes were symptoms measured by ESAS and healthcare utilization. Subgroup analysis by eHealth literacy was conducted. Descriptive statistics and paired t-tests were conducted, with subgroup differences examined using the Mann–Whitney U, Fisher's exact tests, and ANCOVA in SPSS 28.0. User feedback was analyzed using content analysis. Results Feasibility was supported by enrollment, retention, and protocol adherence rates (81.1%, 100%, and 76.7%). Sixty percent of participants completed ≥ 75% of scheduled medication log entries. Overall satisfaction was high. Patients with higher levels of eHealth literacy reported greater perceived effectiveness and stronger intention to use (p < .05). Participants valued medication reminders and symptom monitoring features. A significant decrease in hand–foot syndrome was observed from baseline to follow-up (p = .019), whereas no other symptoms showed significant change. No emergency department visits or unplanned admissions occurred. Conclusions The SAFE demonstrated good feasibility and acceptability. Observed differences related to eHealth literacy highlight the necessity for tailored intervention design. Further randomized controlled trials are warranted to evaluate its effectiveness. Cris registration number KCT0010656. Patent filing 10-2024-0098225.