The Adherence Problem in Cancer Care
One of oncology's most persistent and underappreciated challenges is treatment adherence. Patients prescribed oral cancer medications — hormone therapies, targeted drugs, or immunomodulatory agents — often discontinue their treatment before completing the prescribed course. Studies have consistently found that 20 to 50 percent of breast cancer patients on oral adjuvant therapy stop taking their medication within the first year, usually without telling their oncologist. The consequences can be serious: these medications are prescribed because they demonstrably improve survival rates, and stopping them prematurely eliminates that benefit.
A new study has found that regular telehealth check-ins — virtual appointments with a nurse or oncologist conducted via video or phone — significantly improve treatment adherence among breast cancer patients. The findings add to the growing evidence base for telehealth as a meaningful clinical tool, not just a convenience feature.
Study Design and Results
The study followed approximately 800 breast cancer patients at multiple cancer centers who had been prescribed oral adjuvant therapies, including aromatase inhibitors and CDK4/6 inhibitors. Patients were randomized into two groups: one received standard care with in-person oncology appointments at typical intervals of three to six months, while the other received standard care supplemented by monthly telehealth check-ins with a nurse navigator.
After one year, the telehealth group showed significantly higher medication adherence — 78 percent remained on their prescribed therapy versus 61 percent in the standard care group, a 17 percentage point difference that was statistically significant. The telehealth group also reported lower levels of treatment-related anxiety and better management of side effects, which the researchers identified as the primary mechanism driving the adherence improvement.
Side effects are the leading reason breast cancer patients stop taking oral therapies. Aromatase inhibitors, for example, commonly cause joint pain, hot flashes, and fatigue that patients often tolerate in silence rather than reporting at a quarterly appointment. Monthly telehealth calls gave nurse navigators the opportunity to identify side effect complaints early, offer management strategies, and connect patients with supportive care resources before side effects became severe enough to prompt medication discontinuation.
