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

Oncol Nurs Forum. 2016 May 1;43(3):E94-E103. doi: 10.1188/16.ONF.E94-E103.

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.

Keywords: adherence; adjuvant endocrine therapy; breast cancer; empowerment; quantitative and qualitative mixed method; side effects; therapeutic educational program.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Oral
  • Adult
  • Aged
  • Aged, 80 and over
  • Breast Neoplasms / drug therapy*
  • Chemotherapy, Adjuvant*
  • Endocrine Disruptors / administration & dosage*
  • Feasibility Studies
  • Female
  • France
  • Humans
  • Middle Aged
  • Oncology Nursing / methods*
  • Patient Compliance / psychology*
  • Patient Education as Topic*
  • Pilot Projects

Substances

  • Endocrine Disruptors