Supporting women with adherence to adjuvant endocrine therapy (SWEET): feasibility study of the HT&Me intervention.
McGeagh L., Stewart S-J., Norris R., Wells M., Thompson S., Mawson P., Brett J., Turner M., Wolstenholme J., Dakin H., Donnelly P., Cain H., Rehman F., Kum S., Horne R., Taylor G., Turner L., Rose J., Sharp L., Watson E., SWEET Research Team None.
PURPOSE: Women with estrogen receptor-positive breast cancer are recommended daily oral adjuvant endocrine therapy for at least 5 years, but up to 50 % discontinue early. We assessed an evidence-based, theoretically-informed, patient-centred intervention (HT&Me) to support adjuvant endocrine therapy adherence and improve quality-of-life, in terms of patient acceptability and feasibility to deliver within the UK National Health Service. METHODS: This single arm study aimed to recruit 45 women with stage I-III breast cancer within 14 weeks of first adjuvant endocrine therapy prescription. After completing baseline questionnaires, participants received the HT&Me intervention comprising: (i) a short animation; (ii) two personalised nurse/practitioner consultations (in-person or online); (iii) an interactive web-app; and (iv) regular email reminders. Participants completed follow-up questionnaires at 8 weeks. A sub-sample of participants (n = 20) and health professionals (n = 14) participated in semi-structured interviews. RESULTS: We recruited 51 participants. Participants varied in digital confidence at recruitment (low/moderate, 28 % (n = 14); high, 61 % (n = 31)). HT&Me was demonstrated as feasible to deliver. Overall, 69 % (n = 35) engaged with the web-app; 87 % (n = 40/46) found HT&Me helpful; and 80 % (n = 36/45) reported it motivated them to keep taking endocrine therapy. Both consultation formats were considered acceptable. Completion of outcome measures was high. Health professionals considered HT&Me addresses an important unmet need. CONCLUSIONS: HT&Me is feasible, acceptable and helpful to women. Findings provided valuable insights for design and delivery of the full-scale randomised controlled trial assessing effectiveness now underway (ISRCTN24852890). HT&Me offers potential to improve adjuvant endocrine therapy adherence, thereby reducing recurrence risk for women with estrogen receptor positive breast cancer. STUDY REGISTRATION ISRCTN NUMBER: ISRCTN29401613.