Understanding health literacy's moderating role in remote monitoring for adjuvant endocrine therapy: Findings from a randomized clinical trial.

• DOI: 10.1200/op.2024.20.10_suppl.45
• Publication Date: 2024-09-30T13:33:33Z
• Authors: Ilana Graetz; Xin Hu; Rebecca A. Krukowski; Mehmet Kocak; Janeane Nicole An...; Teresa M. Waters; Andrea Curry; Edward Stepanski; Gregory A. Vidal; Lee S. Schwartzberg
• Keywords: Adjuvant Therapy

45 Background: Despite the efficacy of oral adjuvant endocrine therapy (AET) for improving survival among women with hormone receptor-positive early-stage breast cancer, adherence rates remain low. Our THRIVE study (NCT03592771) investigated effectiveness a mobile health remote monitoring app and without tailored educational messages on AET cancer found no statistically significant treatment effects 1-year overall. Health literacy contributes to patients’ understanding their plans. We conducted post hoc analysis examine if moderates this intervention. Methods: This non-blinded randomized controlled trial included prescribed at large center 14 clinics across three states. Participants used pillbox electronically monitor 1 year completed surveys enrollment. Consented participants were into (1) “App”, receiving access symptom 6 months, increasing/severe symptoms missed doses reported in triggering follow-ups from oncology team; (2) “App+Feedback”, additional weekly text about managing symptoms, adherence, communication months; or (3) “Enhanced Usual Care (EUC).” The primary outcome was captured (≥80% Proportion Days Covered [PDC] vs. < 80%). enrollment survey participant’s sociodemographic characteristics, including race ethnicity, education, household income, literacy. linear probability model measure interaction between arm adherence. Results: Among 304 (104 EUC, 98 App, 102 App+Feedback), 12-month follow-up retention rate 88% (n = 266) 19.4% low Low more prevalent Black (29.4%) White (13.4%) (p 0.001), those incomes below federal poverty level (34.4% 17.2% higher incomes, p 0.02), only high school degree lower education (31.7%) some college (16.4%, 0.01). In group, 80.0% App+Feedback adherent 42.1% 37.9 percentage point (ppt) difference (95% CI: 4.1 71.7, 0.03); group 47.1% 59.0% EUC adherent, -11.8 ppt -27.9 4.3, 0.15). Conclusions: A led literacy, but not Clinical information: NCT03592771 .