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A Feasibility Trial of a Web Based App Intervention in Hormone Positive Breast Cancer Patients to Improve Adherence to Endocrine Therapy

Not Applicable
Recruiting
Conditions
Anatomic Stage I Breast Cancer AJCC v8
Anatomic Stage II Breast Cancer AJCC v8
Hormone Receptor-Positive Breast Carcinoma
HER2-Negative Breast Carcinoma
Interventions
Other: Best Practice
Other: Internet-Based Intervention
Other: Questionnaire Administration
Other: Survey Administration
Registration Number
NCT05488145
Lead Sponsor
Emory University
Brief Summary

This clinical trial looks at the use of an internet-based application (app) intervention in improving adherence to endocrine therapy (ET) among patients with early stage hormone receptor-positive HER2-negative breast cancer. ET can significantly reduce the return of the cancer in patients who are compliant with their treatment regimen. Despite this, adherence to ET is poor due to side effects, lack of social support and timely access to clinicians, and poor patient understanding of the necessity and effectiveness of the therapy. An internet-based app may help patients improve their adherence to ET by providing reminders, side effect mitigation strategies available in the educational videos and from contacting providers/ nurse on the research team directly via the app.

Detailed Description

PRIMARY OBJECTIVE:

I. To assess the feasibility of a web-based app as an intervention to carry out functions such as weekly reminders, improving patient provider communication, improving patient education

SECONDARY OBJECTIVES:

I. To evaluate if high level of adherence to endocrine therapy can be maintained by using our web-based app in early-stage hormone positive breast cancer II. To assess whether the web-based app will improve patient satisfaction, whether patients feel the app helped improve their likelihood of adhering to endocrine therapy by making them feel more confident in their side effect management.

OUTLINE: This is a single arm, feasibility study. 30 patients will be enrolled.

In addition to standard of care, patients will receive access to the web-based application for the study duration (3 months). The app will have the following features: weekly text reminders to continue ET and prompts to report medication side effects, access to educational content explaining common side effects and symptom management strategies, prompts to patients to review this information when they report side effects, and most importantly, the patient will have access to their breast oncology providers to discuss their side effects and ask questions via the app. A feature unique to our app is the educational content readily available to patients. When a patient reports a side effect, the app will direct them to the relevant video explaining that side effect and going over strategies to mitigate them.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
30
Inclusion Criteria
  • Early-stage hormone receptor positive, HER2-negative breast cancer who have completed all recommended (neo)adjuvant chemotherapy, surgery and/or radiation therapy
  • Age >= 18
  • Started on an aromatase inhibitor or Tamoxifen within less than or equal to six months prior to time of enrollment
  • Access to internet from a desktop or a smartphone
  • Ability to speak English
Exclusion Criteria
  • Patients who are her2 neu positive

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Single Arm (internet intervention, best practice)Survey AdministrationPatients receive access to the app in addition to standard of care for 3 months. Through the app, patients receive weekly reminders about hormone therapy, report any side effects, access educational videos that provide tips to help mitigate some of these side effects, and allow patients to send messages to members of our breast cancer team about any questions patients may have about the side effects they may be experiencing.
Single Arm (internet intervention, best practice)Best PracticePatients receive access to the app in addition to standard of care for 3 months. Through the app, patients receive weekly reminders about hormone therapy, report any side effects, access educational videos that provide tips to help mitigate some of these side effects, and allow patients to send messages to members of our breast cancer team about any questions patients may have about the side effects they may be experiencing.
Single Arm (internet intervention, best practice)Internet-Based InterventionPatients receive access to the app in addition to standard of care for 3 months. Through the app, patients receive weekly reminders about hormone therapy, report any side effects, access educational videos that provide tips to help mitigate some of these side effects, and allow patients to send messages to members of our breast cancer team about any questions patients may have about the side effects they may be experiencing.
Single Arm (internet intervention, best practice)Questionnaire AdministrationPatients receive access to the app in addition to standard of care for 3 months. Through the app, patients receive weekly reminders about hormone therapy, report any side effects, access educational videos that provide tips to help mitigate some of these side effects, and allow patients to send messages to members of our breast cancer team about any questions patients may have about the side effects they may be experiencing.
Primary Outcome Measures
NameTimeMethod
Feasibility (Acceptability)Up to 1 year

Feasibility of the web-based app study will encompass:

Acceptability which will be measured by using the System Usability Scale and a score if \>68 will indicate that the app was acceptable to patients. Acceptability will be summarized using descriptive statistics and confidence intervals will be reported using the Clopper-Pearson method.

Feasibility (Compliance)Up to 1 year

Feasibility of the web-based app study will encompass:

Compliance, which is defined as at least 5 responses from patients (via app) over the 12-week period. Compliance will be summarized using descriptive statistics, and confidence intervals will be reported using the Clopper-Pearson method. The goal is to have at least 75% of patients adhere to the app to prove compliance.

Secondary Outcome Measures
NameTimeMethod
AdherenceUp to 1 year

Patients who are adherent to their endocrine therapy for at least 5 days in the week averaged over the 12-week period will be considered to have high level adherence, and those that took their ET for \<5 days/ week would be considered non-adherent. PROMIS medication adherence questions will be used. In addition, the investigators will be observing pharmacy dispensing history and weekly adherence data reported by patients on the app. The proportion who are adherent will be summarized descriptively using frequencies and percentages, and confidence intervals will be reported using the Clopper-Pearson method.

Patient satisfactionUp to 1 year

Patient satisfaction will be measured by utilizing Consumer Assessment of Healthcare Providers and Systems Cancer Care Survey scores. Surveys will be conducted among all participants at baseline and at 12 weeks, regardless of their use of the app, to better understand any barriers to using the app and which aspects of the app were most useful to patients.Satisfaction outcomes will be summarized using descriptive measures. The survey measures the following:

In the last 6 months, how many times did you visit this cancer center to get care from your drug therapy team? Do not include telephone calls or emails, where 0=None, 1=1 to 5 times, 2=6 to 10 times, 3=11 or more times.In the last 6 months, did you contact this cancer center to get an appointment for an illness, injury, or condition that needed care right away? where1=yes and 2=no.

Trial Locations

Locations (4)

Emory University Hospital Midtown

🇺🇸

Atlanta, Georgia, United States

Emory Saint Joseph's Hospital

🇺🇸

Atlanta, Georgia, United States

Emory Johns Creek Hospital

🇺🇸

Johns Creek, Georgia, United States

Emory University Hospital/Winship Cancer Institute

🇺🇸

Atlanta, Georgia, United States

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