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

A qualitative study to identify educational needs and a feasibility study assessing the efficacy of the program.
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SETTING

A comprehensive cancer center, the Lucien Neuwirth Cancer Institute in Saint-Priest-en-Jarez, France.
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SAMPLE: Two consecutive samples (N = 11, N = 6) of women taking adjuvant oral endocrine chemotherapy for breast cancer. 
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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. 
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MAIN RESEARCH VARIABLES: Educational objectives, knowledge, trust in the treatment, and anxiety.
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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).
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CONCLUSIONS

Results from the feasibility study showed promising efficacy for the educational objectives and provided information about how the program could be improved. 
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IMPLICATIONS FOR NURSING: Tailored educational programs conducted by trained nurses may help patients to adhere to and live with the effects of endocrine therapy.