Real-world Evidence of Implementing eHealth Enables Fluent Symptom-based Follow-up of a Growing Number of Patients with Breast Cancer with the Same Healthcare Resources.

BACKGROUND: The growing number of new breast cancer (BC) patients has indicated an urgent need for better tools to monitor patients. Due to the increasing number of unscheduled patient calls, two digital applications were implemented: a callback application (CA) and a digital cancer follow-up application (CFUA). The aim of this study was to evaluate the implementation and added value of digital applications for healthcare professionals in monitoring BC patients from 2012 to 2020. MATERIALS AND METHODS: As of the end of 2020, 1420 follow-up BC patients were enrolled in the CFUA, which covered 70% of the BC patients in the follow-up phase in the clinic. All unscheduled telephone calls and digital contacts were recorded from January 2015 to December 2020. RESULTS: The implementation of the CA revealed low telephone accessibility (56%), which was improved by 55% by the end of 2020 due to the implementation of the CFUA. In 2019, 59% of all phone service contacts were digitally prepared, and contact reasons were classified by the patients. One of the most important findings was that BC patient contacts more than tripled during the nine-year study period, and these patients could be treated by the same number of nurses due to the implementation of the CA and CFUA. Feedback from two nurses' surveys favored the use of the CFUA. CONCLUSION: Our study clearly demonstrates that new digital tools are useful in the challenge of a growing number of BC patients in surveillance who should be handled with limited health care resources.

Electronic Patient-reported Outcomes During Breast Cancer Adjuvant Radiotherapy.

INTRODUCTION: Patient-reported outcomes (PROs) have become extremely important in following patients' health-related quality of life during cancer treatments. The aim of this study was to assess the usefulness of electronic PROs (ePROs) during adjuvant radiotherapy (RT) in patients with early breast cancer. MATERIALS AND METHODS: A registry trial was conducted with a total of 253 patients with breast cancer receiving RT. Adverse event data were collected from 9 items on the ePRO questionnaires that were administered before RT (N = 253), at the end of RT (± 3 days; N = 234), 1 month after RT (N = 230), and 3 months (N = 225) after RT. The patient characteristics and treatment details were collected from the medical records. RESULTS: The patients have started actively using the ePRO system, and the response rates were high (82.6%). During RT, 39.3% of the ePRO responses were about symptoms, and 60.7% were about treatment-related questions or advice. Patients treated with hypofractionated RT reported fewer local adverse events such as skin symptoms (P = .001) and pain (P = .002) than those who received conventional RT. One of the main findings of this study was that tiredness, fatigue, and anxiety were commonly reported on the patients' ePRO questionnaires, but they were rarely recorded in the medical records. CONCLUSION: Patients were motivated to use the ePRO system, and the response rates were high. Additionally, patients seemed to find that the ePRO system was an easy way to contact their own health care professionals. More attention should be paid to mental well-being during visits to the clinic.

Effective Antiemetic Therapy Is Important With Adjuvant Anthracycline-based Chemotherapy in Breast Cancer.

BACKGROUND: The aim of this study was to evaluate whether aprepitant is an effective antiemetic when combined with 5-hydroxytryptamine 3-(5-HT3) receptor antagonists and dexamethasone in patients with breast cancer receiving anthracycline-based chemotherapy. PATIENTS AND METHODS: A retrospective study was carried out on 229 patients with breast cancer between 2004 and 2014. All the patients received three cycles of cyclophosphamide, epirubicin and 5-fluorouracil. 5-HT3 receptor antagonists and dexamethasone were used in 132 patients (cohort 1). 5-HT3 receptor antagonists, dexamethasone and aprepitant were used in 97 patients (cohort 2). The primary outcome was to compare the grades of emesis between cohorts 1 and 2. RESULTS: The incidence of moderate and severe nausea was significantly lower in cohort 2 than in cohort 1 (p<0.05) during all three cycles. Additionally, the complete response rate (i.e. no nausea) was higher in cohort 2 (p<0.05). CONCLUSION: The combination of 5-HT3 receptor antagonists, dexamethasone and aprepitant was more effective as an antiemetic treatment than the standard dual combination of 5-HT3 receptor antagonists and dexamethasone for patients with breast cancer receiving anthracycline-based adjuvant chemotherapy.