Quality improvement study of a telemedicine-supported home-injection model for breast cancer patients receiving GnRHa therapy

Premenopausal patients with breast cancer are treated with gonadotropin-releasing hormone agonist (GnRHa) therapy to suppress ovarian function. Therapy requires subcutaneous or intramuscular injection and is routinely administered during clinic visits. A quality improvement study at Memorial Sloan Kettering Cancer Center (New York, NY) evaluated feasibility and acceptability of a telemedicine-supported home-injection program for patients with breast cancer receiving GnRHa therapy. The program was found to have high feasibility and acceptability among 24 women, with high home-injection completion rates (95.8% for ≥ 1 injection; 79.2% for 2 injections; and 75% for continued injections) and strong endorsement from both patients and clinicians. 'Saved time' and 'More control over my schedule' were most patient-reported benefits of the program. Some women who chose to participate could not due to insurance denials or high copay costs. The authors conclude that these findings suggest that telemedicine-supported home injection delivery for patients with breast cancer receiving GnHRa therapy is a feasible care model that has high patient acceptability, but implementation barriers need to be addressed prior to scaling.