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

Aurélie Bourmaud

Vanessa Rousset

Véronique Regnier-Denois

Olivier Collard

Jean-Philippe Jacquin

Yacine Merrouche

Joelle Lapoirie

Fabien Tinquaut

Laurence Lataillade

Franck Chauvin

breast cancer, adjuvant endocrine therapy, therapeutic educational program, adherence, side effects, quantitative and qualitative mixed method, empowerment
ONF 2016, 43(3), E94-E103. DOI: 10.1188/16.ONF.E94-E103

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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