Symptom Monitoring App Reduces High-Cost Health Visits for Breast Cancer Patients

By Shelby Crosier

Breast cancer makes up about one third of all new cancer diagnoses in U.S. women every year, and 1 in 8 women will be diagnosed at some point in their life. After skin cancer, it is the second most common cancer in women.

Most women diagnosed with breast cancer in the U.S. have hormone receptor-positive tumors, which doctors treat with adjuvant endocrine therapy (AET). AET increases survival rates, but it also has negative effects like joint pain and hot flashes. Those negative effects lower adherence to AET (make patients less likely to take their AET treatment as directed).

In a new study published in JAMA Network Open, a team of researchers led by Ilana Graetz, PhD, associate professor of health policy and management, evaluated an intervention to improve AET adherence. They tested a mobile app where women could report when they took their AET medication and any symptoms they experienced, with certain reported symptoms alerting the oncology team. Some participants also received weekly text messages with personally tailored information related to AET and managing symptoms.

What They Found

Using the app, with or without also receiving tailored text messages, did not improve AET adherence. However, there were secondary positive effects. Compared to participants who did not have access to the monitoring app, those who used the app and received tailored messages:

• Had fewer in-person medical encounters, likely because symptoms that triggered alerts could be resolved by a phone call with a nurse, rather than a visit to the clinic.
• Had fewer high-cost health care encounters (such as emergency department visits and hospitalizations).

Why It Matters

“Improving long-term endocrine therapy adherence is a complex problem that may require more comprehensive or targeted interventions,” says Graetz. “Even though we did not succeed in improving adherence, reducing high-cost encounters is highly consequential for patients, health systems, and payers."