Improving Adherence to Adjuvant Endocrine Therapy in Breast Cancer Through a Therapeutic Educational Approach: A Feasibility Study

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Abstract

Purpose/Objectives:

To develop and test the feasibility of a tailored therapeutic educational program, with the aim of improving adherence to oral endocrine adjuvant chemotherapy in women with breast cancer.

Design:

A qualitative study to identify educational needs and a feasibility study assessing the efficacy of the program.

Setting:

A comprehensive cancer center, the Lucien Neuwirth Cancer Institute in Saint-Priest-en-Jarez, France.

Sample:

Two consecutive samples (N = 11, N = 6) of women taking adjuvant oral endocrine chemotherapy for breast cancer.

Methods:

A mixed qualitative and quantitative method was used. The participants’ representations of disease and treatment were explored through one-on-one interviews and then translated into educational needs, which were used to develop a tailored therapeutic education program. The pilot study evaluated the reach and efficacy using before-and-after comparisons.

Main Research Variables:

Educational objectives, knowledge, trust in the treatment, and anxiety.

Findings:

Five educational objectives (acquiring knowledge, improving communication skills, managing anxiety, managing side effects, and improving adherence) were identified through 11 interviews. A three-session program was developed. Eight of the 23 patients invited to participate in a pilot study accepted, and six completed the intervention. Knowledge improved from 38.9 of 100 preintervention to 69.4 of 100 postintervention (p = 0.045). Trust in treatment showed a trend to improvement from 5.5 of 10 to 8 of 10 (p = 0.14), but anxiety did not change significantly; anxiety went from 6 to 7 (p = 0.88).

Conclusions:

Results from the feasibility study showed promising efficacy for the educational objectives and provided information about how the program could be improved.

Implications for Nursing:

Tailored educational programs conducted by trained nurses may help patients to adhere to and live with the effects of endocrine therapy.

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