Background:
Adherence to adjuvant endocrine therapy (AET) is critical for reducing recurrence in estrogen receptor-positive (ER+) breast cancer, yet up to 50% of women discontinue treatment prematurely. Psychological, behavioural, and informational barriers often underpin non-adherence. The HT&Me intervention—a multi-component, theory-informed self-directed support package—was co-developed with patients and clinicians to address these barriers and support quality of life (QoL).
Objective:
To assess the feasibility and acceptability of HT&Me on AET adherence and quality of life within the UK National Health Service.
Methods:
This single-arm feasibility study recruited 51 women with stage I–III ER+ breast cancer within 14 weeks of initiating AET. The HT&Me intervention included: (1) an educational animation; (2) two personalised nurse-led consultations (in-person, virtual or by telephone); (3) an interactive web-app; and (4) email "nudges" to reinforce engagement. Mixed methods were used to evaluate feasibility, acceptability, and engagement. Semi-structured interviews were conducted with a sub-sample of participants (n=20) and health professionals (n=14).
Results:
The intervention was feasible to deliver, with high retention (98%) and follow-up (92%). Most participants found the intervention helpful (87%) and reported improved understanding (91%) and motivation to persist with AET (80%). Participants valued the interactive tools such as the side effect diary, setting reminders, and setting goals. Healthcare professionals identified HT&Me as meeting an important unmet need and found both remote and face to face delivery acceptable. Fidelity of delivery exceeded 95%.
Conclusions:
HT&Me is an acceptable and feasible intervention, integrating digital and health professional support to address barriers to AET adherence and improving QoL. Findings informed refinements for a full-scale randomised controlled trial currently underway (ISRCTN24852890).
Implications for Practice:
HT&Me offers a scalable model to improve adherence and QoL in breast cancer survivorship, supporting person-centred, evidence-based psycho-oncology care.