Abstract P4-11-16: Feasibility and patient satisfaction with a smartphone application to improve medication adherence among patients with breast cancer
Authors: Accordino Melissa K , Ulene Sophie , Honan Erin , Trivedi Meghna S , Crew Katherine D , Harden Erik , Law Cynthia , Hershman Dawn L 
Published: March 2022

Abstract
Introduction: Low medication adherence is associated with worse outcomes among patients with breast cancer (BC). Retrospective studies have shown decreased survival in patients with BC who are non-adherent to endocrine therapy, but less is known about newer oral cancer therapies and the impact on adherence to medications for chronic non-cancer conditions. New strategies to improve global medication adherence are needed. We assessed the feasibility and patient satisfaction of the Medisafe smartphone application in the initial phase of a trial to increase global medication adherence. Methods: Patients treated with oral anti-neoplastic therapy for treatment of BC were eligible. Enrolled patients received individualized instruction on Medisafe app installation and use. The Medisafe app sends patients push notification reminders at the times specified for each of their standing oral medications. Patients self-report whether each medication dose was taken or missed directly in the app. Patients were followed for 12 weeks. The primary endpoint was feasibility, defined as completion of the 12-week study intervention. uMARS (end-user Mobile Application Rating Scale) questionnaires were used to assess patient satisfaction with the Medisafe app at week 12. The objective feedback component of the uMARS contains 16 questions and includes 4 objective quality subscales: engagement, functionality, aesthetics, and information quality. Each question is answered on a 1-5 scale (5 indicates highest satisfaction), and mean responses were used to calculate an overall satisfaction score and a satisfaction score for each subsection. Results: Between July 2020 and July 2021, 58 patients were enrolled. The mean participant age was 58 years (range 31 - 87). As of June 30,2020 20 patients reached the 12-week endpoint. Of these patients, 18 (90%) completed the 12-week intervention. Of the 17 patients who completed the uMARS questionnaire, the mean overall uMARS score of the Medisafe app was 3.8 (SD 0.6). Table 1 displays the results for the uMARS subscales, which include a mean functionality score of 4.0 (SD 0.7) and mean information quality score of 4.1 (SD 0.7). Notably, 70.6% of participants reported that the app was easy to use and clearly designed, and 76.5% reported that the app’s content was appropriately designed for its specific target audience. Of the 13 patients who reported viewing educational information within the app, 84.6% reported that the information seemed credible. Almost half of patients (43.8%) reported that the app increased their awareness of the importance of addressing health behavior. Conclusions: Our early findings suggest that the use of a smartphone application to improve medication adherence among patients with cancer is feasible, with a high rate of participant completion. Furthermore, high patient-reported satisfaction with the Medisafe app suggests acceptability to promote long-term behavior change. Table 1: Patient Reported Satisfaction with the Medisafe App Evaluated Assessed by the Objective Feedback Component of the uMARS (end-user Mobile Application Rating Scale) Questionnaire at Week 12 (n=17)
uMARS Objective ScoreMean± SDOverall3.8± 0.6  Engagement3.2± 0.8  Functionality4.0± 0.7  Performance4.2± 0.8  Ease of use4.1± 1.0  Aesthetics4.0± 0.6  Information Quality4.1± 0.7  Quality of info3.8± 0.8  Visual info4.3± 0.9  Credibility4.5± 0.8
Citation Format: Melissa K Accordino, Sophie Ulene, Erin Honan, Meghna S Trivedi, Katherine D Crew, Erik Harden, Cynthia Law, Dawn L Hershman. Feasibility and patient satisfaction with a smartphone application to improve medication adherence among patients with breast cancer [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P4-11-16.