Highlights
- •Long-term adherence is a challenge for people prescribed with adjuvant endocrine therapy.
- •The FOR-AD study helps understand the benefits and disadvantages of this treatment for patients, but also for HCP.
- •This study highlights the importance of the patient/HCP relationship in adhering to adjuvant ET.
- •Participants suggest the role of a nurse navigator to improve the care process and facilitate the patient/HCP relationship.
Abstract
Purpose
Adjuvant endocrine therapy (ET) for 5–10 years is the backbone of the therapeutic
strategy in patients with hormone receptor positive (HR+) early breast cancer (BC).
However, long-term adherence to adjuvant ET represents a major challenge for most
patients. According to prior studies, side effects of adjuvant ET are an important
reason for poor adherence. In contrast, better communication and relational bond between
patients and healthcare providers (HCPs) may improve adherence. The FOR-AD (Focus
on non-adherence) study aimed at better understanding the representation of adjuvant
ET by patients and their HCPs, in order to improve the care process.
Methods
Three focus groups of premenopausal women (receiving adjuvant ET for variable amount
of time) and two focus groups of HCPs (including oncologists, pharmacists, and nurses)
were conducted, each including around ten participants. Thematic analyses using a
general inductive approach were constructed to report participants’ representations.
Results
Two main themes emerged across groups, and appeared of major importance.
Representations on adjuvant ET were often homogenous within each group, but differed
between patients and their HCPs. The relationship between both groups was considerably
discussed, particularly its importance in facilitating adherence to adjuvant ET. Suggestions
on improving the care process were also given, such as systematically including psychologists
in follow-up care paths and having a nurse navigator follow patients under treatment
with adjuvant ET.
Conclusion
The present qualitative exploration may help buildi future tailored interventions
to improve adherence to adjuvant ET, in particular regarding the role of nurse navigators.
Keywords
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Article info
Publication history
Published online: December 26, 2022
Accepted:
December 14,
2022
Received in revised form:
December 6,
2022
Received:
June 10,
2022
Identification
Copyright
© 2022 Elsevier Ltd. All rights reserved.
