Pharmacist-led remote follow-up service for non-metastatic breast cancer patients: a prospective randomised controlled trial of pharmaceutical intervention

Abstract

Background: Non-metastatic breast cancer accounts for 87.8% of breast cancer cases. However, the high risk of drug adverse drug reactions due to multiple combined medications, along with the urgent need for out-of-hospital medication adherence and management, poses substantial challenges. Traditional treatments often fail to meet the full-cycle management needs of patients. Remote pharmaceutical follow-up, as an emerging model, may address these issues. This study aimed to investigate the intervention effect of remote pharmaceutical services via a follow-up app on non-metastatic breast cancer patients. Methods: From May 2023 to March 2025, 178 patients with non-metastatic breast cancer were enrolled and randomly assigned to an intervention group (receiving remote pharmaceutical follow-up via an app) or a control group (receiving only routine treatment), with a 6-month follow-up period. The primary outcome was the incidence of severe adverse drug reactions, while secondary outcomes included medication adherence scores, pharmaceutical knowledge scores, and quality of life assessments. Results: The incidence of severe adverse drug reactions in the intervention group (20.2%) was significantly lower than that in the control group (50.0%, P < 0.01), with notable improvements particularly in non-hematological adverse drug reactions. The intervention group also demonstrated significantly higher pharmaceutical knowledge scores and medication adherence scores compared to the control group (P < 0.05). In terms of quality of life, the intervention group showed greater improvements in symptom scores and overall composite scores (P < 0.01), with faster recovery of global health and functional scores in the late follow-up phase. Conclusion: Remote pharmaceutical services delivered via a follow-up app effectively reduce the incidence of severe adverse drug reactions and improve medication knowledge, adherence, and quality of life in non-metastatic breast cancer patients. This model provides a viable new approach for out-of-hospital management and highlights the value of pharmacists in the full-cycle management of oncology care. Future research should further explore preventive strategies for hematological adverse drug reactions and extend the follow-up period to refine the clinical application of this management model.