On average, participants were 58 years of age, 14 months from the end of primary treatment, and prescribed AET approximately 13 months prior to study entry (Table 1). The majority of participants were non-Latina white (92%) and prescribed aromatase inhibitors (63%).
Feasibility: Completion.All participants (100%) completed a 30-day Wisepill monitoring baseline, exceeding the study’s 95% completion goal, and 98.86% (87/88) completed the six-month post-baseline Wisepill monitoring period.
Feasibility: Technical difficulties. Over the 7-month study, 13.64% of participants (n = 12) experienced technical difficulties using Wisepill which required a total of 38 contacts to resolve, including losing connectivity (n = 9, contacts = 25), not registering pillbox openings (n = 1, contacts = 6), charging cable not working (n = 1, contacts = 4), and needing to reset the battery (n = 1, contacts = 3). These contacts were almost exclusively initiated by the research team, specifically all those related to losing connectivity and not registering pill box openings were only research-team initiated.
Patient acceptability: Quantitative ratings. On a 5-point Likert-type scale, on average, participants found the Wisepill box to be moderately helpful (M = 3.15, SD = 1.31), moderately convenient (M = 3.66, SD = 1.36), and were somewhat likely (M = 3.40, SD = 1.49) to recommend the device to someone else taking AET.
Patient acceptability: Qualitative interviews.Women responded to open-ended prompts about the acceptability of Wisepill and offered suggestions for future use. Most breast cancer survivors found Wisepill convenient to use (n = 27). For example, when asked about the convenience of the Wisepill, one participant stated:
Many women (n = 22) also found benefits in using the Wisepill (even though the daily reminder feature was inactive). Breast cancer survivors found the real-time tracking features of the Wisepill to be a source of motivation, for example, one participant stated:
I think the idea that someone was tracking you and that they were going to ask you about it…was a little more motivating to make sure I took it. (1046)
The mere presence of the device was a helpful reminder and benefit for others:
It made me aware of every day that I was taking my medications. And it helped me keep track of them. (1068)
While others did not perceive any benefits from their use of Wisepill, they did note the ease of use:
Did I experience any benefits in using it? No, it was convenient to have. It was easy to open instead of opening a pill bottle, so that was kind of nice, you just kind of slid it flipped it open. (1073)
Many participants (n = 16) reported no changes in their behavior or motivation to take AET because their adherence was being monitored. For example, when asked whether knowing that her adherence data were being monitored had changed her behavior, one participant stated:
I really don’t think it affected it at all. Because yeah, I just don’t think that that box motivated me in any way to take my medications. I take them because they’re prescribed… (1066)
Other participants (n = 9) reported positively changing their adherence behavior or feeling more motivated or committed to taking AET because of the knowledge that Wisepill was remotely transmitting their adherence data. One participant stated:
I think occasionally like I said, I don’t want to take it today. And then knowing that somebody was going to know whether I took it or not, okay fine I’ll take it. (1037)
Participants were also asked for their recommendations for future use of the Wisepill device. Suggestions included daily access to an online Wisepill medication log (n = 10), a device-initiated reminder (alarm, blinking light, text message) to take their medication (n = 9), and a 7-day internal divider to track their medication (n =11; Table 2).