Use of a web-based app to improve breast cancer symptom management and adherence for aromatase inhibitors: a randomized controlled feasibility trial

• DOI: 10.1007/s11764-018-0682-z
• Publication Date: 2018-02-28T22:28:11Z
• Authors: Ilana Graetz; Caitlin N. McKillop; Edward Stepanski; Gregory A. Vidal; Janeane N. Anderson; Lee S. Schwartzberg
• Keywords: Adult; Internet; Drug-Related Side Effects and Adverse Reactions; Aromatase Inhibitors; Breast Neoplasms; Pilot Projects; Middle Aged; Mobile Applications; Medication Adherence; 3. Good health; Survival Rate; 03 medical and health sciences; 0302 clinical medicine; Electronic Health Records; Feasibility Studies; Humans; Female; Patient Reported Outcome Measures; Self Report; Neoplasm Recurrence, Local; Aged

For postmenopausal women with hormone receptor-positive breast cancer, long-term use of aromatase inhibitors (AIs) significantly reduces the risk of cancer recurrence and improves survival. Still, many patients are nonadherent due to adverse side effects. We conducted a pilot randomized controlled trial to test the use of a web-based application (app) designed with and without weekly reminders for patients to report real-time symptoms and AI use outside of clinic visits with built-in alerts to patients' oncology providers. Our goal was to improve symptom burden and medication adherence.Forty-four women with early-stage breast cancer and a new AI prescription were randomized to either an App+Reminder (weekly reminders to use app) or an App (no reminders) group. Pre- and post-assessment data were collected from all participants.Participants in the App+Reminder group had higher weekly app usage rate (74 vs. 38%, p < 0.05) during the intervention and reported higher AI adherence at 8 weeks (100 vs. 72%, p < 0.05). Symptom burden increase was higher for the App group compared to the App+Reminder group but did not reach statistical significance.Weekly reminders to use a web-based app to report AI adherence and treatment-related symptoms demonstrated feasibility and improved short-term AI adherence, which may reduce symptom burden for women with breast cancer and a new AI prescription.If short-term gains in adherence persist, this low-cost intervention could improve survival outcomes for women with breast cancer. A larger, long-term study should examine if AI adherence and symptom burden improvements persist for a 5-year treatment period.