Supporting women with adherence to adjuvant endocrine therapy (SWEET): feasibility study of the HT&Me intervention

Journal article

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.

Authors: McGeagh, L; Stewart, S-J; Norris, R; Wells, M; Thompson, S

• Publication status: Published
• Peer review status: Peer reviewed
• Publisher: Elsevier
• Journal: European Journal of Oncology Nursing
• Volume: 80
• Article number: 103026
• Publication date: 2025-11-01
• Acceptance date: 2025-10-28
• DOI: 10.1016/j.ejon.2025.103026
• EISSN: 1532-2122
• ISSN: 1462-3889
• Language: English
• Keywords: feasibility; adjuvant endocrine therapy; breast cancer; adherence; intervention; support package