The Application of eHealth in Symptom Management of Patients With Breast Cancer During Endocrine Therapy: Scoping...

Endocrine therapy is a fundamental treatment for hormone receptor-positive breast cancer. However, treatment-related symptoms may lead to poor adherence and premature discontinuation, adversely affecting clinical outcomes. eHealth technology interventions have been widely applied as potential tools to support patient education, symptom management, and adherence.

This review aimed to evaluate the application, effectiveness, and limitations of eHealth technologies in symptom management among patients with breast cancer undergoing endocrine therapy.

A systematic literature search was conducted across 9 databases, including MEDLINE Complete, Academic Search Complete, PubMed, and CINAHL Ultimate, covering studies published between February 2015 and February 2025. Keywords included "breast cancer," "endocrine therapy," and "ehealth," along with synonyms and related terms. Eligible studies examined the use of eHealth interventions in patients with breast cancer undergoing endocrine therapy. From 1352 records, 30 (2.2%) studies were included after screening and full-text review.

The 30 included studies comprised 13 (43.3%) randomized controlled trials, 7 (23.3%) single-arm studies, 3 (10%) retrospective analyses, 2 (6.7%) observational studies, 3 (10%) mixed methods studies, and 2 (6.7%) qualitative studies. eHealth interventions, primarily mobile apps, telemonitoring systems, and SMS text messaging, demonstrated benefits in short-term symptom management, such as reductions in hot flashes, joint pain, anxiety, and sexual distress and improved medication adherence. However, evidence regarding long-term adherence and quality of life outcomes remains inconsistent. Considerable heterogeneity existed in study designs, adherence measures, and intervention components. Nurses were considered key contributors in implementing and monitoring eHealth interventions.

eHealth interventions show promise in improving symptom management and short-term adherence among patients with breast cancer receiving endocrine therapy. Methodological limitations and variability across studies restrict the strength of conclusions. Future research should prioritize long-term outcomes, standardized measures, and integration into routine clinical practice while incorporating perspectives from multiple stakeholders.