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William J. Gradishar, MD, FACP, FASCO
William J. Gradishar, MD, FACP, FASCO
Posted: Monday, November 4, 2024
Cognitive behavioral, therapist-delivered interventions may increase adherence to adjuvant endocrine therapy among patients with breast cancer, according to an exploratory study published in JCO Oncology Practice. Kelcie D. Willis, PhD, of Massachusetts General Hospital, Boston, and colleagues found that patients who reported worse adherence benefited in particular. In addition, they identified patients’ own perceptions of the convenience of adjuvant endocrine therapy, its efficacy, and potential problems with adherence as specific factors that may be modified through clinician-led discussions.
“Our findings underscore the essential role of breast cancer clinicians in optimizing intervention effects,” the investigators noted. “Finally, because patients earlier in their adjuvant endocrine therapy treatment course were more likely to experience improvements in objective adherence, our findings suggest that this may be a critical period for effective behavioral intervention.”
A total of 100 patients with early-stage breast cancer reporting distress related to adjuvant endocrine therapy were enrolled in the study. Participants were randomly assigned to receive either a cognitive behavioral, therapist-delivered telehealth intervention or standard medication monitoring. Electronic pill bottles were used to track objective medication adherence rates. Participants also self-reported their adherence on the Medication Adherence Report Scale-5 and their perceptions of adjuvant endocrine therapy on the Cancer Therapy Satisfaction Questionnaire at baseline.
Among participants who reported more perceived difficulties with adherence at baseline, those who received the cognitive intervention had higher adherence rates over time compared with those who received medication monitoring (P < .01). Patients who reported higher expectations of therapeutic benefit also had improved adherence rates when receiving the intervention (P = .01). Finally, those who perceived adjuvant endocrine therapy as convenient and had been taking it for less time had higher adherence rates with the cognitive intervention than with standard medication monitoring.
Disclosure: Dr. Willis reported no conflicts of interest. For full disclosures of the other study authors, visit ascopubs.org.
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