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Testing a behavioral intervention to improve adherence to adjuvant endocrine therapy (AET)
Rebecca A Shelby1, Caroline S Dorfman1, Hayden B Bosworth2
1Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, United States.
Contemporary Clinical Trials
|November 26, 2018
Summary
This study tests a telephone-based coping skills training (CST-AET) to improve adherence to adjuvant endocrine therapy (AET) for breast cancer patients. The intervention aims to reduce symptoms and improve long-term outcomes.
Area of Science:
- Oncology
- Behavioral Science
- Health Services Research
Background:
- Adjuvant endocrine therapy (AET) is crucial for hormone receptor-positive breast cancer, but poor adherence is common.
- Symptom burden and early discontinuation of AET significantly increase healthcare costs and mortality.
- Current recommendations suggest up to 10 years of AET, highlighting the need for sustained adherence strategies.
Purpose of the Study:
- To evaluate the efficacy of a novel telephone-based coping skills training for AET adherence (CST-AET).
- To assess the impact of CST-AET on symptom interference and cost-effectiveness.
- To improve long-term breast cancer outcomes through enhanced AET adherence.
Main Methods:
- A randomized trial involving 400 participants from diverse settings.
- Intervention group received CST-AET (10 nurse calls over 6 months) with interactive voice messaging reinforcement.
- Adherence monitored in real-time using wireless smart pill bottles; symptom interference and cost-effectiveness analyzed as secondary outcomes.
Main Results:
- Real-time adherence monitoring via smart pill bottles over 18 months.
- Assessment of symptom interference, including pain, vasomotor symptoms, sleep, and vaginal dryness.
- Evaluation of the intervention's cost-effectiveness in a medically underserved and rural population.
Conclusions:
- The CST-AET protocol offers a timely solution to improve adherence to long-term AET.
- If effective, CST-AET could reduce the burden of AET, leading to cost-effective clinical practice changes.
- Successful implementation of CST-AET may improve breast cancer patient outcomes by ensuring sustained treatment adherence.
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