Symptom Monitoring Using Patient-Report to Improve Medication Use

This study will test whether oncology teams can adapt and combine models from intensive oncologic care and chronic noncancer care to support long-term oral oncologic medication adherence through better symptom monitoring and management. It will identify patients at risk of nonadherence through electronic health records and target them with a symptom monitoring and management intervention. The study will use patient-reported outcomes (PROs) to identify symptoms that may cause nonadherence and will involve clinical pharmacist-led follow-up. Objectives: 1. Assess the impact of the intervention on adherence to oral endocrine therapy. 2. Evaluate the durability of adherence one-year post-intervention. 3. Describe the impact on symptoms and explore mechanisms for adherence improvement. Intervention: During the intervention phase, patients will receive symptom monitoring and pharmacist-led management based on patient-reported outcomes (PROs). Symptom Monitoring: 1. Patients will report symptoms monthly for 12 months either online or via an interactive voice recording (IVR) system. 2. Symptoms will be assessed using PROs focusing on issues like pain, hot flashes, anxiety, and more. 3. Severe symptoms will trigger follow-up for management. Symptom Management: 1. After the initial symptom report, patients will have a face-to-face or virtual visit with a clinical pharmacist. 2. The visit will be tailored based on patient preference and pharmacist judgment. 3. Pharmacists will discuss symptom reports, provide management recommendations, and coordinate with oncologists for prescriptions if needed. 4. All interactions will be documented in the electronic health record (EHR) for research analysis. Control Phase: Breast cancer patients on AET are typically seen every six months over a 5 to 10-year course, with more frequent visits if complications arise. Control group participants will continue to follow this schedule and receive an FDA document with tips for medication adherence. Consent Process: Informed consent will be obtained in person or remotely.