Use of a web-based app to improve breast cancer symptom management and adherence for aromatase inhibitors: a randomized controlled feasibility trial

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 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.