Research ArticleResearchPatient EducationWorkflow

Tailored remote support may help breast cancer survivors with low self-efficacy

The American journal of managed care (PubMed)Aug 1, 2026

AI-summarized from the linked source. Educational brief, not medical advice.

Brief summary

A post hoc randomized-trial analysis found lower symptom-management self-efficacy identified breast cancer survivors with poorer outcomes who appeared to benefit most from remote monitoring plus tailored messages.

What NurseJet pulled from the source

The analysis included 264 women prescribed adjuvant endocrine therapy and compared enhanced usual care, weekly app monitoring, and app monitoring plus tailored supportive texts. Higher baseline self-efficacy was associated with lower symptom burden and greater adherence. At a low self-efficacy score of 30, estimated adherence was 52.7% with app plus feedback versus 17.8% with usual care, but the confidence interval was wide and the subgroup analysis was post hoc.

Why this matters for nurses

Endocrine-therapy symptoms and low confidence managing them can undermine long-term treatment. Oncology nurses can identify support needs, normalize symptom reporting, and close the loop with the oncology team while recognizing that an app is an adjunct rather than a replacement for care.

Bedside takeaway

Low confidence managing endocrine-therapy symptoms can be a cue for more tailored follow-up and adherence support.

How This Applies in Practice

Use this when: Following a breast cancer survivor who is taking adjuvant endocrine therapy and reports symptoms, missed doses, or low confidence managing treatment.

On your shift

Assess symptom burden, self-management confidence, missed doses, access barriers, and the patient's preferred method of follow-up.
Use teach-back for the prescribed regimen and explain how and when to report symptoms through the approved remote or clinic pathway.
Escalate persistent symptoms, adherence barriers, or treatment concerns to the oncology team for individualized management.

Keep in mind: The subgroup finding was post hoc and imprecise. Follow the oncology plan, facility policy, and provider orders.

Key takeaways

The post hoc analysis included 264 women from a randomized trial of app-based symptom and adherence monitoring.
Higher baseline symptom-management self-efficacy was associated with lower symptom burden and greater odds of endocrine-therapy adherence.
The tailored-feedback intervention showed its largest estimated adherence benefit at lower self-efficacy levels.
The low-self-efficacy estimate had a wide confidence interval, and effects diminished and became nonsignificant at higher self-efficacy levels.

Practice implications

Ask how confident the patient feels managing symptoms and the daily regimen, then assess barriers, symptom burden, missed doses, and support preferences. Route concerns through the survivorship or oncology pathway and use remote monitoring only within the approved program.

Limitations & cautions

This was a post hoc effect-modification analysis rather than a prespecified primary comparison. Adherence was recorded with a connected pillbox, the low-self-efficacy estimate was imprecise, and the findings do not establish that the same intervention will work in other populations or platforms.
AI-summarized from the linked source. Review the original article before applying to practice.

Citations

Exact source links

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The American journal of managed care (PubMed)

The American journal of managed care (PubMed). Remote Monitoring and Self-Efficacy: Implications for Breast Cancer Survivorship Outcomes.

Open original source

https://pubmed.ncbi.nlm.nih.gov/42663546/

Professional education only

This summary does not replace clinical judgment, facility policy, provider orders, or official guidelines. Verify practice changes against the original source and local protocol.

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Renal failure (PubMed)Sep 7, 2026Research Article

A single-center retrospective cohort found that approximately one quarter of laboratory-defined acute kidney injury cases on internal medicine wards were not documented, particularly when maximal creatinine was lower.

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Research ArticleResearchQuality ImprovementAI summary · original source linked below

Among 161 adult hospitalizations meeting serum-creatinine criteria for acute kidney injury, 39 cases (24.2%) were undocumented. Length of stay and in-hospital mortality did not differ significantly by documentation status.

Key takeaways

In the 149 hospitalizations with a demonstrable creatinine change, 33 cases (22.1%) were undocumented.
Higher maximal creatinine was associated with lower adjusted odds of underdocumentation.
The study did not test whether a detection or documentation intervention improves care or outcomes.

Why this matters on shift

A smaller creatinine rise may receive less attention even when it meets the study's laboratory definition of acute kidney injury, which can affect how renal risk is communicated across the inpatient team.

Bedside takeaway

Trend ordered renal-function results and communicate clinically important changes through local escalation and documentation workflows.

Nursing implications

Trend ordered renal-function results and communicate clinically important changes through the care team according to local escalation and documentation workflows.

Limitations & cautions

Abstract-only summary. This was a retrospective, single-center study of 161 hospitalizations; urine-output criteria and reliable preadmission creatinine values were unavailable, and the reference creatinine method may affect case classification.
AI-summarized from the linked source. Review the original article before applying to practice.

Citations · exact source links

Renal failure (PubMed). Underdocumentation of laboratory-defined acute kidney injury in internal medicine wards: a retrospective cohort study.

Open original sourceFull brief

AI-summarized from the linked source. Review the original article before applying to practice.

European heart journal (PubMed)Sep 6, 2026Research Article

In the pragmatic TARGET-D randomized trial, vitamin D dosing titrated to a serum target did not significantly reduce the composite of death, recurrent myocardial infarction, heart-failure hospitalization, or stroke after myocardial infarction.

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Research ArticleResearchMedication SafetyPatient EducationAI summary · original source linked below

Among 630 participants followed for an average of 4.2 years, major cardiovascular events occurred in 15.7% with targeted vitamin D management and 18.4% with usual care (hazard ratio 0.85, 95% CI 0.58 to 1.24; P=0.40).

Key takeaways

At baseline, 87% of participants had a 25-hydroxyvitamin D level of 40 ng/mL or lower.
The primary composite outcome and the individual outcomes of death, heart-failure hospitalization, and stroke were not significantly different.
A lower recurrent-MI rate was a secondary finding and should not override the nonsignificant primary result.

Why this matters on shift

The trial cautions against presenting targeted vitamin D supplementation as a proven strategy for reducing major cardiovascular events after myocardial infarction.

Bedside takeaway

Present vitamin D as prescribed supplementation, not as a replacement for established post-MI secondary prevention.

Nursing implications

Reinforce the prescribed secondary-prevention plan and avoid implying that vitamin D replaces therapies with established post-MI benefit.

Limitations & cautions

Abstract-only summary. The trial included 630 participants, 78.1% were men, the primary confidence interval included benefit and no benefit, and individual secondary outcomes were not the primary endpoint.
AI-summarized from the linked source. Review the original article before applying to practice.

Citations · exact source links

European heart journal (PubMed). Targeted vitamin D supplementation and major adverse cardiovascular events after myocardial infarction: the TARGET-D trial.

Open original sourceFull brief

AI-summarized from the linked source. Review the original article before applying to practice.

Supportive care in cancer (PubMed)Sep 5, 2026Research Article

A small randomized trial found larger one-month reductions in reported supportive-care needs among colorectal cancer caregivers who received smartphone-based education than with routine care.

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Research ArticleResearchPatient EducationAI summary · original source linked below

Eighty family caregivers at two teaching hospitals in Tehran were randomized. Compared with routine care, the intervention group reported larger reductions in total needs and in health-service, psychological-emotional, work-social, and information domains after four weeks.

Key takeaways

The intervention was designed around family caregivers' supportive-care needs.
All four measured need domains favored the smartphone-education group at four weeks.
The abstract reports statistical significance but does not provide effect sizes or describe the educational content in detail.

Why this matters on shift

Caregiver education is part of oncology care, and mobile delivery may extend structured support beyond brief in-person teaching encounters.

Bedside takeaway

Ask caregivers about unmet information and support needs, then reinforce teaching with approved digital resources.

Nursing implications

Assess what caregivers still need to know and use approved digital education as a supplement to individualized teaching and follow-up.

Limitations & cautions

Abstract-only summary. The trial included 80 caregivers at two hospitals, assessed self-reported needs after only four weeks, and did not report patient outcomes or effect sizes in the abstract.
AI-summarized from the linked source. Review the original article before applying to practice.

Citations · exact source links

Supportive care in cancer (PubMed). The effect of a smartphone-based educational intervention on the supportive care needs of family caregivers of patients with colorectal cancer: a randomized controlled trial.

Open original sourceFull brief

AI-summarized from the linked source. Review the original article before applying to practice.

How This Applies in Practice

Key takeaways

Practice implications

Limitations & cautions

Exact source links

More updates for this clinical area

One in four laboratory-defined AKI cases went undocumented on medicine wards

Targeted vitamin D did not significantly reduce major cardiovascular events after MI

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