Use of a web-based app to improve breast cancer symptom management and aromatase inhibitor adherence: A pilot randomized controlled trial.

e12044 Background: For postmenopausal women with hormone receptor-positive breast cancer, use of aromatase inhibitors (AI) significantly reduces the risk of cancer recurrence and improves survival, but many patients are nonadherent due to adverse side effects. We conducted a pilot randomized controlled trial of a web-enabled application (app) to provide real-time symptom monitoring between visits and facilitate management of treatment-related adverse symptoms among patients with hormone receptor-positive breast cancer and a new AI prescription. Methods: Patients were randomized into two groups: (1) App+Reminder: had access to the app and received weekly reminders via text or email to use it, or (2) App: had access to the app but did not receive reminders. The app asked patients about their AI use in the last 7 days and about new symptoms related to the treatment. New symptoms with severity in a clinically-relevant range or AI nonadherence triggered email alerts to the patient’s providers. The main analyses compared AI adherence and changes in quality of life. Results: We enrolled 44 patients, 21 in the App+Reminder and 23 in the App group; 83% of patients approached agreed to participate, 23% were African-American, and 32% were over the age of 65. Overall, 74% of participants in the App+Reminder group used the app at least once per week compared with 38% in the App group (p<0.01). Reported AI adherence 8 weeks after initiation was significantly higher among those in the App+Reminder group compared with the App group (100% vs. 72%, p=0.01). Using a differences-in-differences analysis, we found that the decrease in quality of life 8 weeks after AI initiation was substantially larger, but not statistically significant, in the App group compared with App+Reminder (difference=7.6, p=0.191). Conclusions: Use ofa web-enabled app to provide real-time monitoring of AI adherence and treatment-related symptoms with weekly reminders significantly improves short-term AI adherence and may limit reductions in quality of life.If short-term gains in adherence persist, this low-cost intervention could improve survival outcomes for women with hormone receptor-positive breast cancer. Clinical trial information: NCT02957526.

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Use of a web-based app to improve breast cancer symptom management and aromatase inhibitor adherence.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.5_suppl.89 ◽

2017 ◽

Vol 35 (5_suppl) ◽

pp. 89-89 ◽

Cited By ~ 1

Author(s):

Ilana Graetz ◽

Caitlin N McKillop ◽

Edward J. Stepanski ◽

Gregory A. Vidal ◽

Lee Steven Schwartzberg

Keyword(s):

Breast Cancer ◽

Quality Of Life ◽

Usual Care ◽

Hormone Receptor ◽

Usual Care Group ◽

Care Group ◽

Short Term ◽

Hormone Receptor Positive ◽

Positive Breast Cancer

89 Background: For postmenopausal women with hormone receptor-positive breast cancer, long-term use of aromatase inhibitors (AI) significantly reduces the risk of cancer recurrence and improves disease free and overall survival. Despite the known benefits of AIs, many patients are nonadherent due to adverse side effects. We conducted a pilot randomized controlled trial of a web-enabled application (app) to provide real-time monitoring and better management of treatment-related adverse symptoms among patients with hormone-receptor positive breast cancer and a new AI prescription. Methods: Eligible patients who agreed to participate were randomized into either: App: had access to the app and received weekly reminders to use it; or Usual Care: had access to the app but did not receive reminders. Concerning responses and trends triggered email alerts to the patient’s providers, who then could review responses to manage ongoing treatment and make therapeutic adjustments. The main analyses compared overall AI adherence using the Morisky Medication Adherence Scale and quality of life using the Functional Assessment of Cancer Therapy Endocrine Symptoms (FACT-ES). Results: We enrolled 44 patients, 21 in the App and 23 in the Usual Care groups; 83% of patients approached agreed to participate, 23% were African-American, and 32% were over the age of 65. Overall, 74% of participants in the App group used the app at least once per week compared with 38% in the Usual Care group (p<0.01). Reported AI adherence at 8 weeks after initiation was significantly higher among App compared with the Usual care group at 8 weeks (100% vs. 72%, p=0.01). Using a differences-in-differences analysis, we found a substantially larger decrease in quality of life in the Usual Care group compared with the App (-11.5 vs. -3.9, p=0.191), although this difference did not reach statistical significance. Conclusions: App use with weekly reminders significantly improved short-term AI adherence. If short-term gains in adherence persist, this low-cost intervention could improve survival outcomes for women with hormone-receptor positive breast cancer.

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5086 POSTER Quality of Life – Patient-reported Outcomes in Patients With Advanced Hormone Receptor Positive Breast Cancer

European Journal of Cancer ◽

10.1016/s0959-8049(11)71528-3 ◽

2011 ◽

Vol 47 ◽

pp. S356

Author(s):

Y. Su ◽

E. Flood ◽

J. Devlen ◽

S. Tsay ◽

K. Beusterien ◽

...

Keyword(s):

Breast Cancer ◽

Quality Of Life ◽

Hormone Receptor ◽

Patient Reported Outcomes ◽

Hormone Receptor Positive ◽

Patient Reported ◽

Positive Breast Cancer

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Physical activity, health‐related quality of life, and adjuvant endocrine therapy–related symptoms in women with hormone receptor–positive breast cancer

Cancer ◽

10.1002/cncr.33054 ◽

2020 ◽

Vol 126 (17) ◽

pp. 4059-4066

Author(s):

Vanessa B. Sheppard ◽

Chiranjeev Dash ◽

Sarah Nomura ◽

Arnethea L. Sutton ◽

Robert Lee Franco ◽

...

Keyword(s):

Breast Cancer ◽

Quality Of Life ◽

Physical Activity ◽

Hormone Receptor ◽

Health Related Quality ◽

Hormone Receptor Positive ◽

Related Quality ◽

Health Related ◽

Positive Breast Cancer

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Aromatase Inhibitors in Postmenopausal Women with Hormone Receptor-Positive Breast Cancer: Profiles of Psychological Symptoms and Quality of Life in Different Patient Clusters

Oncology ◽

10.1159/000509651 ◽

2020 ◽

pp. 1-12

Author(s):

Claudia Borreani ◽

Sara Alfieri ◽

Gabriele Infante ◽

Rosalba Miceli ◽

Paola Mariani ◽

...

Keyword(s):

Breast Cancer ◽

Quality Of Life ◽

Postmenopausal Women ◽

Aromatase Inhibitors ◽

Hormone Receptor ◽

Psychological Symptoms ◽

Hormone Receptor Positive ◽

Positive Breast Cancer

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Randomized Controlled Trial of an Educational Intervention for Managing Fatigue in Women Receiving Adjuvant Chemotherapy for Early-Stage Breast Cancer

Journal of Clinical Oncology ◽

10.1200/jco.2005.01.271 ◽

2005 ◽

Vol 23 (25) ◽

pp. 6027-6036 ◽

Cited By ~ 102

Author(s):

Patsy Yates ◽

Sanchia Aranda ◽

Maryanne Hargraves ◽

Bev Mirolo ◽

Alexandra Clavarino ◽

...

Keyword(s):

Breast Cancer ◽

Quality Of Life ◽

Randomized Controlled Trial ◽

Functional Assessment ◽

Controlled Trial ◽

Intervention Group ◽

Randomized Controlled ◽

Cancer Related Fatigue ◽

Numeric Rating

PurposeTo evaluate the efficacy of a psychoeducational intervention in improving cancer-related fatigue.Patients and MethodsThis randomized controlled trial involved 109 women commencing adjuvant chemotherapy for stage I or II breast cancer in five chemotherapy treatment centers. Intervention group patients received an individualized fatigue education and support program delivered in the clinic and by phone over three 10- to 20-minute sessions 1 week apart. Instruments included a numeric rating scale assessing confidence with managing fatigue; 11-point numeric rating scales measuring fatigue at worst, average, and best; the Functional Assessment of Cancer Therapy–Fatigue and Piper Fatigue Scales; the Cancer Self-Efficacy Scale; the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire C30; and the Hospital Anxiety and Depression Scale. For each outcome, separate analyses of covariance of change scores between baseline (T1) and the three follow-up time points (T2, T3, and T4) were conducted, controlling for the variable's corresponding baseline value.ResultsCompared with the intervention group, mean difference scores between the baseline (T1) and immediate after the test (T2) assessments increased significantly more for the control group for worst and average fatigue, Functional Assessment of Cancer Therapy–Fatigue, and Piper fatigue severity and interference measures. These differences were not observed between baseline and T3 and T4 assessments. No significant differences were identified for any pre- or post-test change scores for confidence with managing fatigue, cancer self-efficacy, anxiety, depression, or quality of life.ConclusionPreparatory education and support has the potential to assist women to cope with cancer-related fatigue in the short term. However, further research is needed to identify ways to improve the potency and sustainability of psychoeducational interventions for managing cancer-related fatigue.

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