Providers’ perspectives on adherence to hormonal therapy in breast cancer survivors. Is there a role for the digital health feedback system?

Abstract

Objective: Despite the benefits of hormonal therapy (HT) adherence remains suboptimal in ER positive breast cancer patients. Medication adherence is challenging to assess and tends to be overestimated. The Digital Health Feedback System (DHFS) consists of an ingestible sensor attached to a pill that sends intake date and time to a smart phone or computer. Patients can share this information with health care providers and other persons. The DHFS can also send reminders. This mixed methods study examined providers' perceptions of HT medication adherence. The potential role of the DHFS in enhancing medication tracking and adherence was also explored. Methods:We conducted semi-structured interviews with key informants (N=10). Questions examined perceptions about adherence barriers and facilitators, challenges tracking adherence, and views on the DHFS. Findings informed the development of a survey that was administered online (N=19).Results: Providers emphasized the importance of fostering open and trustful communication around adherence. The most mentioned challenges to assessing adherence were the patient not disclosing discontinuation immediately (78.9%) and over-reporting adherence (57.9%). The perceived potential benefits of DHFS were the ability to track adherence better (94.7%) and reminders to take the medication (68.4%). Safety to ingest a sensor was as a major perceived barrier (8 4.2%).

What influences aromatase inhibitor continuation intention among breast cancer survivors?

“…In addition, the discrepancy between intention and behavior may be relevant. In this study, AI continuation intention was measured instead of adherence (i.e., a behavioral variable), considering the lack of reliability and evidence regarding self-reported measures of medication adherence [29]. Although intention to take medication is a predictor of medication adherence [6], actual behavior can differ.…”

Systematic adaptation of the adherence improving self‐management strategy to support breast cancer survivors' adherence to adjuvant endocrine therapy: An intervention mapping approach

“…Identified as eligible: (Accordino & Hershman, 2013 ; Banning, 2012 ; Cahir, Guinan, et al, 2015 ; Chlebowski et al, 2014 ; Gotay & Dunn, 2011 ; Lambert, Balneaves, Howard, & Gotay, 2018 ; Mausbach et al, 2015 ; McCowan & Thompson, 2012 ; Miaskowski et al, 2008 ; Milata et al, 2018 ; Moon, Moss‐Morris, Hunter, Carlisle, et al, 2017; Murphy et al, 2012 ; Paranjpe et al, 2019 ; Puts et al, 2014 ; Sawesi et al, 2014 ; Van Liew et al, 2014 ; Wassermann & Rosenberg, 2017 )

APPENDIX B2 Flow chart qualitative articles. Identified as eligible: (Bluethmann et al, 2017 ; Brett et al, 2018 ; Cahir, Dombrowski, et al, 2015 ; Farias, 2016 ; Farias et al, 2017 ; Hackett et al, 2018 ; Harrow et al, 2014 ; Humphries et al, 2018 ; Hurtado‐de‐Mendoza, Cabling, et al, 2019 ; Iacorossi et al, 2018 ; Lambert, Balneaves, Howard, Chia, et al, 2018; Moon, Moss‐Morris, Hunter, & Hughes, 2017 ; Pellegrini et al, 2010 ; Pieters et al, 2019 ; Samuel et al, 2017 ; Toledo et al, 2019 ; van Londen et al, 2014 ; Wheeler et al, 2015 ; Wouters et al, 2013 ; Yamamoto et al, 2015 )

APPENDIX B3 Flow chart quantitative articles. Identified as eligible: (Brett et al, 2018b ; Cabling et al, 2018 ; Hagen et al,

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“… Flow chart qualitative articles. Identified as eligible: (Bluethmann et al, 2017 ; Brett et al, 2018 ; Cahir, Dombrowski, et al, 2015 ; Farias, 2016 ; Farias et al, 2017 ; Hackett et al, 2018 ; Harrow et al, 2014 ; Humphries et al, 2018 ; Hurtado‐de‐Mendoza, Cabling, et al, 2019 ; Iacorossi et al, 2018 ; Lambert, Balneaves, Howard, Chia, et al, 2018; Moon, Moss‐Morris, Hunter, & Hughes, 2017 ; Pellegrini et al, 2010 ; Pieters et al, 2019 ; Samuel et al, 2017 ; Toledo et al, 2019 ; van Londen et al, 2014 ; Wheeler et al, 2015 ; Wouters et al, 2013 ; Yamamoto et al, 2015 ) …”

“…A P P E N D I X B 2 Flow chart qualitative articles. Identified as eligible: (Bluethmann et al, 2017;Brett et al, 2018;Farias, 2016;Farias et al, 2017;Hackett et al, 2018;Harrow et al, 2014;Humphries et al, 2018;Hurtado-de-Mendoza, Cabling, et al, 2019;Iacorossi et al, 2018;Lambert, Balneaves, Howard, Chia, et al, 2018;Pellegrini et al, 2010;Pieters et al, 2019;Samuel et al, 2017;Toledo et al, 2019;van Londen et al, 2014;Wheeler et al, 2015;Wouters et al, 2013;Yamamoto et al, 2015) A P P E N D I X B 3 Flow chart quantitative articles. Identified as eligible: (Brett et al, 2018b;Cabling et al, 2018;Hagen et al, 2019;Hurtadode-Mendoza, Carrera, et al, 2019;Kroenke et al, 2018;Kuba et al, 2018;Lee & Min, 2018;Yin, Harrell, et al, 2018; Motivation .…”

A Novel Digital Pill System for Medication Adherence Measurement and Reporting: Usability Validation Study

“…A systematic review of publications on oral anticancer medications from 2003 to 2015 showed that medication adherence rates varied widely from 46% to 100% [ 7 ]. In interviews with patients with breast cancer, de Mendoza et al [ 8 ] found that 78.9% of the patients failed to report medication discontinuation immediately and 57.9% overreported medication adherence.…”