Department of Preventive Medicine, College of Medicine, University of Tennessee Health Science Center, 66 N. Pauline St., Ste. 633, Memphis, TN, 38163, USA.
Department of Economics, State University of New York at Cortland, 28 Graham Ave., Cortland, NY, 13045, USA.
J Cancer Surviv. 2018 Aug;12(4):431-440. doi: 10.1007/s11764-018-0682-z. Epub 2018 Feb 28.
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.
对于激素受体阳性乳腺癌的绝经后妇女,长期使用芳香化酶抑制剂(AIs)可显著降低癌症复发的风险并提高生存率。尽管如此,由于不良反应,许多患者不依从。我们进行了一项试点随机对照试验,以测试使用一种带有和不带有每周提醒的基于网络的应用程序(app),让患者实时报告症状和 AI 使用情况,而无需在就诊时间之外,并内置警报以提醒患者的肿瘤学提供者。我们的目标是减轻症状负担和提高药物依从性。
将 44 名患有早期乳腺癌和新 AI 处方的女性随机分配到 App+提醒(每周提醒使用 app)或 App(无提醒)组。所有参与者都在干预前和干预后进行了评估。
在干预期间,App+提醒组的每周应用程序使用率更高(74%对 38%,p<0.05),并且在 8 周时报告的 AI 依从性更高(100%对 72%,p<0.05)。与 App+提醒组相比,App 组的症状负担增加更高,但未达到统计学意义。
每周提醒使用基于网络的应用程序报告 AI 依从性和与治疗相关的症状证明是可行的,并改善了短期 AI 依从性,这可能会减轻新 AI 处方乳腺癌女性的症状负担。
如果短期依从性的提高持续存在,这种低成本干预措施可能会改善乳腺癌女性的生存结果。一项更大、长期的研究应该检查 AI 依从性和症状负担改善是否持续 5 年的治疗期。