At-home Breast Oncology Care Delivered With E-health Solutions

The COVID-19 pandemic has significantly impacted healthcare service delivery, highlighting the need for high quality virtual patient care. Our team has developed a multi-dimensional remote eHealth solution for newly diagnosed breast cancer patients and their practitioners to use during the diagnostic and follow-up period. The ABODE study involved development of a Breast Cancer Treatment Application (app) which will facilitate virtual consultations, deliver patient education material, and collect patient reported outcome measures (PROMs). Using a randomized controlled trial design, the team will evaluate a variety of outcomes for breast cancer patients who will use the app throughout their diagnosis and treatment period.

Primary Objective: To compare changes in patient activation (assessed by PAM-13) over 1 year among newly diagnosed breast cancer patients between those using the app and those receiving standard care.

Secondary Objectives:

1. Compare additional PROMs between the standard care and intervention groups
2. Describe health service outcomes among app users
3. Explore end-user experience of using the app
4. Measure activity levels using wearable devices

To measure the effect of the app compared to the standard care approach, the study team will conduct a randomized controlled trial of 200 newly diagnosed breast cancer patients seen at a tertiary care cancer centre in Ontario, Canada. The intervention group (n=100) will receive access to the app in addition to standard care for 13 months following their diagnosis. The control group (n=100) will have standard care. Both arms will be provided with a Fitbit wearable device.

The PAM-13 scale assesses patient activation, defined as the knowledge and confidence a patient has in self- management of one's health. Research team will test whether use of the app improves PAM-13 scores at the 12-month follow-up.

Additionally, secondary outcomes will be assessed with data from additional patient-reported outcome measures (PROMs), chart review, hospital administrative databases, and Fitbits. All participants will complete PROMs at baseline, 6- and 12- months post diagnosis via REDCap survey links sent through email. The intervention group will have access to the app for 13 months following randomization.

Eligibility Criteria:
Inclusion Criteria:

* Females (assigned female at birth)\*
* Diagnosed with first, primary invasive BC
* Must have surgery as their first step in treatment pathway
* Age≥18
* Access to an electronic device with connection to the internet
* A valid email address
* Can communicate in English \*Since BC risk is sex-related and based on physiological values, our inclusion criteria are based on sex (not gender)

Exclusion criteria:

* Males (assigned male at birth), as BC surgical treatment options and experiences are different
* Diagnosed with non-operable breast cancer
* Stage 4/metastatic (whether determined at diagnosis or during surgery)
* Those with hearing or visual challenges
* Neo-adjuvant chemotherapy
* Should not be enrolled in any other UHN study using an e-Health application
* Breast cancer surgery is scheduled for less 5 business days after enrollment