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

2017 ◽  
Vol 35 (5_suppl) ◽  
pp. 89-89 ◽  
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.

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

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e12044-e12044
Author(s):  
Ilana Graetz ◽  
Caitlin N McKillop ◽  
Edward J. Stepanski ◽  
Gregory A. Vidal ◽  
Lee Steven Schwartzberg
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Hormone Receptor ◽  
Controlled Trial ◽  
Short Term ◽  
Randomized Controlled ◽  
Hormone Receptor Positive ◽  
Pilot Randomized Controlled Trial ◽  
Positive Breast Cancer

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.

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

Cancer ◽  
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

scholarly journals Endocrine Therapy Toxicity: Management Options

2014 ◽  
pp. e25-e30 ◽  
Author(s):  
N. Lynn Henry
Keyword(s):  
Breast Cancer ◽  
Side Effects ◽  
Endocrine Therapy ◽  
Hormone Receptor ◽  
Response To Therapy ◽  
Management Options ◽  
Hormone Receptor Positive ◽  
Research Investment ◽  
Positive Breast Cancer

Treatment with adjuvant endocrine therapy, including tamoxifen and the aromatase inhibitors, has resulted in notable improvements in disease-free and overall survival for patients with hormone receptor-positive breast cancer. Despite their proven benefit, however, adherence to and persistence with the medications is poor in part because of bothersome side effects that can negatively affect quality of life. Retrospective analyses have identified possible predictors of development of toxicity. Reports have also suggested that development of toxicity may be a biomarker of better response to therapy. In addition, there has been considerable research investment into the management of these side effects, which may lead to improved adherence and persistence with therapy. However, although notable advances have been made, much more remains to be done to provide patients with truly personalized therapy for hormone receptor-positive breast cancer.

Health-related quality of life from a phase 3 randomized trial of fulvestrant 500 mg vs anastrozole for hormone receptor-positive advanced breast cancer (FALCON).

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 1048-1048 ◽  
Author(s):  
John Forsyth Russell Robertson ◽  
Kwok-Leung Cheung ◽  
Shinzaburo Noguchi ◽  
Zhimin Shao ◽  
Arnold Degboe ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Hormone Receptor ◽  
Health Related Quality ◽  
Phase 3 ◽  
Hormone Receptor Positive ◽  
Related Quality ◽  
Health Related ◽  
Scale Range

1048 Background: The Phase 3 randomized FALCON trial (NCT01602380) demonstrated improved progression-free survival with fulvestrant 500 mg (F) vs anastrozole 1 mg (A) in postmenopausal women with hormone receptor-positive (HR+) locally advanced or metastatic breast cancer (BC) without prior endocrine therapy (hazard ratio [HR] 0.797, 95% confidence interval [CI] 0.637-0.999; p = 0.0486; Robertson et al. Lancet 2016). Overall health-related quality of life (HRQoL) was maintained and similar for F and A. There was no evidence of a detriment with F vs A in time to deterioration for both Trial Outcome Index (TOI; HR 0.90, 95% CI 0.70-1.15; p = 0.4008) and Functional Assessment of Cancer Therapy for Breast Cancer (FACT-B) total score (HR 0.84, 95% CI 0.66-1.07; p = 0.1594). We present additional analyses of patient (pt)-reported HRQoL outcomes from FALCON. Methods: Women with HR+ BC were randomized 1:1 to F (Days 0, 14, 28, then every 28 days) or A (daily) until disease progression or discontinuation. HRQoL was assessed by FACT-B questionnaire (TOI [summary of physical and functional well-being and breast cancer subscale scores] and FACT-B total score) at randomization and every 12 weeks during treatment. HRQoL data post-treatment (with or without progression) were also collected. Results: 462 pts were randomized (F, n = 230; A, n = 232). Compliance to FACT-B during treatment ranged from 84.6-100.0%. Mean change from baseline in TOI (scale range 0-92) and FACT-B total score (scale range 0-144) remained broadly stable (approximately ±3 points to Week 132) and similar between arms during treatment. HRQoL was also maintained in FACT-B subscales. Approximately one third of pts had improved TOI (≥ +6 points) and FACT-B (≥ +8 points) total scores from baseline up to Week 144 of treatment with F (ranges 26.4-45.0%, and 20.0-35.8%, respectively) and A (ranges 18.6-32.9%, and 22.7-37.9%, respectively). Conclusions: Compliance to the FACT-B questionnaire on treatment with F and A for HR+ BC in the FALCON trial was good; mean change from baseline in TOI and FACT-B total score was maintained, and similar proportions of pts had improved TOI and FACT-B total score in both arms. Clinical trial information: NCT01602380.

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