So we’ve known for a long time that adherence to endocrine therapy is suboptimal at best. Some real world evidence saying 30 to 50 percent of women may discontinue their treatment earlier than their prescribed five years due to side effects or other issues. So we endeavored to improve this by using ePROs and smart pill bottles to improve adherence to adjuvant endocrine therapy...
So we’ve known for a long time that adherence to endocrine therapy is suboptimal at best. Some real world evidence saying 30 to 50 percent of women may discontinue their treatment earlier than their prescribed five years due to side effects or other issues. So we endeavored to improve this by using ePROs and smart pill bottles to improve adherence to adjuvant endocrine therapy. And we gave this to men and women for one year total. We found that the use of the smart pill bottles with triggered follow-ups if people had severe symptoms nearly doubled the odds of being adherent to adjuvant endocrine therapy at 12 months. Whereas we didn’t see this effect when we looked at it with ePROs, which were given through their electronic health record portal. We also looked at a number of key subgroups like age, year of endocrine therapy, race, and we did not find that those were associated with a difference in adherence at 12 months. So pretty strongly suggesting that the smart pill bottle really did help these men and women. So I think one thing to consider is certainly the cost and resources, certainly of the bottles themselves. But when we did this study, we actually created an investigator dashboard that we could view people’s adherence in real time. And that has, of course, with it both personal and technical upkeep that comes along with it. I think there also requires some degree of familiarity for the patients with that technology. So reminders were given via text messaging for patients to take their medicine every day. So obviously someone needs to have a text or smartphone-abled device. And I think that you have to consider the size of the healthcare enterprise that’s implementing it. We’re a 32-hospital system, so a pretty large healthcare network. And of course, when you think about rolling this out to other places, you’d have to consider the infrastructure they have in place, both digitally and geographically, when rolling that out.
