Both 'Vitamin L for Life' and 'One Milligram of Satan': A Multi-Perspective Qualitative Exploration of Adjuvant Endocrine Therapy Use after Breast Cancer
| Autor: | Tavis S. Campbell, Kirsti I Toivonen, Devesh Oberoi, Linda E. Carlson, Joshua A. Rash, Kathryn King-Shier, Katherine-Ann Piedalue |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
media_common.quotation_subject education Psychological intervention Information needs Breast Neoplasms Article 03 medical and health sciences 0302 clinical medicine Breast cancer breast cancer medicine Humans 030212 general & internal medicine RC254-282 media_common Research ethics business.industry Endocrine therapy Neoplasms. Tumors. Oncology. Including cancer and carcinogens adjuvant endocrine therapy persistence Vitamins medicine.disease Combined Modality Therapy Discontinuation Feeling Chemotherapy Adjuvant 030220 oncology & carcinogenesis Family medicine qualitative Female Thematic analysis Neoplasm Recurrence Local business |
| Zdroj: | Current Oncology Current Oncology, Vol 28, Iss 227, Pp 2496-2515 (2021) Volume 28 Issue 4 Pages 227-2515 |
| ISSN: | 1718-7729 1198-0052 |
| Popis: | Adjuvant endocrine therapy (AET) is recommended after hormone receptor-positive breast cancer to reduce risk of recurrence, but adherence is sub-optimal in many women. Behavioral interventions have been ineffective in improving adherence rates to AET. This qualitative descriptive study investigates factors that support women in AET use and suggestions for interventions to improve AET use and management. Interviews with women who persisted with AET (n = 23), women who discontinued AET (n = 15), and healthcare providers (HCPs oncologists, oncology residents, and pharmacists n = 9) were conducted, transcribed, and described using thematic analysis. Data collection stopped once saturation occurred (i.e., no new codes or themes emerged during interviews). Two researchers created codes and developed themes in an iterative process a third researcher verified the representativeness of final themes. This study was approved by the Health Research Ethics Board of Alberta (ID: HREBA.CC-17-0513). Women who persisted described being prepared for side effects and having self-management strategies, strong rationale for AET use, supportive HCPs, and available resources as relevant factors. Women who discontinued described feeling overwhelmed by side effects, information needs, drawbacks of AET, helpful/unhelpful experiences with HCPs, and contextual factors as relevant to their discontinuation. HCPs described health system-related and patient-related barriers, side effect management, and patient-provider interactions as relevant to supporting AET use. The considerable overlap in themes among the three groups suggests broad recognition of salient factors relevant to AET use and that associated strategies to improve use may be acceptable to patients and providers alike. Factors supporting AET use could include the following: education (which may be necessary but insufficient), developing a strong personal rationale for use, being prepared for side effects, having side effect management strategies, reciprocal communication between patients and HCPs, and accessible resources. |
| Databáze: | OpenAIRE |
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