Abstract
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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