Abstract:Objective: Despite the benefits of hormonal therapy (HT) adherence remains suboptimal in ER positive breast cancer patients. Medication adherence is challenging to assess and tends to be overestimated. The Digital Health Feedback System (DHFS) consists of an ingestible sensor attached to a pill that sends intake date and time to a smart phone or computer. Patients can share this information with health care providers and other persons. The DHFS can also send reminders. This mixed methods study examined provide… Show more
“…In addition, the discrepancy between intention and behavior may be relevant. In this study, AI continuation intention was measured instead of adherence (i.e., a behavioral variable), considering the lack of reliability and evidence regarding self-reported measures of medication adherence [29]. Although intention to take medication is a predictor of medication adherence [6], actual behavior can differ.…”
Purpose: Aromatase inhibitors (AIs) are widely prescribed for postmenopausal women with breast cancer and are known to cause musculoskeletal pain. This study aimed to identify factors associated with AI continuation intention among breast cancer survivors (BCS). Methods: A cross-sectional survey was conducted on 123 BCS (stages I-III), who had been taking AIs for at least 6 weeks. Participants were recruited from a cancer center in Goyang, Korea, from September to November 2019. Descriptive statistics, Welch analysis of variance, Pearson correlation coefficients, and simple linear regression were used for the analysis. Results: Beliefs about endocrine therapy was a significant predictor of AI continuation intention (β=.66, p<.001). The majority of participants (87.0%) reported experiencing musculoskeletal pain since taking AIs and the score for the worst pain severity within 24 hours was 5.08±2.80 out of 10. Musculoskeletal pain, however, was not associated with AI continuation intention. Fear of cancer recurrence (FCR) was clinically significant (≥13) for 74.0% of the respondents (mean, 17.62±7.14). Musculoskeletal pain severity and pain interference were significantly associated with FCR (r=.21, p<.05; r=.35, p<.01, respectively). Pain interference was significantly associated with beliefs about endocrine therapy (r=-.18, p<.05). Conclusion: AI continuation intention can be modified by reinforcing patients' beliefs about endocrine therapy. Musculoskeletal pain may have a negative effect on beliefs about endocrine therapy and increase FCR among BCS. Thus, awareness of musculoskeletal pain during AI therapy should be raised and further research is required to develop multidisciplinary pain management strategies and clinical guidelines to reinforce beliefs about endocrine therapy.
“…In addition, the discrepancy between intention and behavior may be relevant. In this study, AI continuation intention was measured instead of adherence (i.e., a behavioral variable), considering the lack of reliability and evidence regarding self-reported measures of medication adherence [29]. Although intention to take medication is a predictor of medication adherence [6], actual behavior can differ.…”
Purpose: Aromatase inhibitors (AIs) are widely prescribed for postmenopausal women with breast cancer and are known to cause musculoskeletal pain. This study aimed to identify factors associated with AI continuation intention among breast cancer survivors (BCS). Methods: A cross-sectional survey was conducted on 123 BCS (stages I-III), who had been taking AIs for at least 6 weeks. Participants were recruited from a cancer center in Goyang, Korea, from September to November 2019. Descriptive statistics, Welch analysis of variance, Pearson correlation coefficients, and simple linear regression were used for the analysis. Results: Beliefs about endocrine therapy was a significant predictor of AI continuation intention (β=.66, p<.001). The majority of participants (87.0%) reported experiencing musculoskeletal pain since taking AIs and the score for the worst pain severity within 24 hours was 5.08±2.80 out of 10. Musculoskeletal pain, however, was not associated with AI continuation intention. Fear of cancer recurrence (FCR) was clinically significant (≥13) for 74.0% of the respondents (mean, 17.62±7.14). Musculoskeletal pain severity and pain interference were significantly associated with FCR (r=.21, p<.05; r=.35, p<.01, respectively). Pain interference was significantly associated with beliefs about endocrine therapy (r=-.18, p<.05). Conclusion: AI continuation intention can be modified by reinforcing patients' beliefs about endocrine therapy. Musculoskeletal pain may have a negative effect on beliefs about endocrine therapy and increase FCR among BCS. Thus, awareness of musculoskeletal pain during AI therapy should be raised and further research is required to develop multidisciplinary pain management strategies and clinical guidelines to reinforce beliefs about endocrine therapy.
“…Identified as eligible: (Accordino & Hershman, 2013 ; Banning, 2012 ; Cahir, Guinan, et al, 2015 ; Chlebowski et al, 2014 ; Gotay & Dunn, 2011 ; Lambert, Balneaves, Howard, & Gotay, 2018 ; Mausbach et al, 2015 ; McCowan & Thompson, 2012 ; Miaskowski et al, 2008 ; Milata et al, 2018 ; Moon, Moss‐Morris, Hunter, Carlisle, et al, 2017; Murphy et al, 2012 ; Paranjpe et al, 2019 ; Puts et al, 2014 ; Sawesi et al, 2014 ; Van Liew et al, 2014 ; Wassermann & Rosenberg, 2017 ) APPENDIX B2 Flow chart qualitative articles. Identified as eligible: (Bluethmann et al, 2017 ; Brett et al, 2018 ; Cahir, Dombrowski, et al, 2015 ; Farias, 2016 ; Farias et al, 2017 ; Hackett et al, 2018 ; Harrow et al, 2014 ; Humphries et al, 2018 ; Hurtado‐de‐Mendoza, Cabling, et al, 2019 ; Iacorossi et al, 2018 ; Lambert, Balneaves, Howard, Chia, et al, 2018; Moon, Moss‐Morris, Hunter, & Hughes, 2017 ; Pellegrini et al, 2010 ; Pieters et al, 2019 ; Samuel et al, 2017 ; Toledo et al, 2019 ; van Londen et al, 2014 ; Wheeler et al, 2015 ; Wouters et al, 2013 ; Yamamoto et al, 2015 ) APPENDIX B3 Flow chart quantitative articles. Identified as eligible: (Brett et al, 2018b ; Cabling et al, 2018 ; Hagen et al, …”
Section: Appendix B1mentioning
confidence: 99%
“… Flow chart qualitative articles. Identified as eligible: (Bluethmann et al, 2017 ; Brett et al, 2018 ; Cahir, Dombrowski, et al, 2015 ; Farias, 2016 ; Farias et al, 2017 ; Hackett et al, 2018 ; Harrow et al, 2014 ; Humphries et al, 2018 ; Hurtado‐de‐Mendoza, Cabling, et al, 2019 ; Iacorossi et al, 2018 ; Lambert, Balneaves, Howard, Chia, et al, 2018; Moon, Moss‐Morris, Hunter, & Hughes, 2017 ; Pellegrini et al, 2010 ; Pieters et al, 2019 ; Samuel et al, 2017 ; Toledo et al, 2019 ; van Londen et al, 2014 ; Wheeler et al, 2015 ; Wouters et al, 2013 ; Yamamoto et al, 2015 ) …”
Section: Appendix B1mentioning
confidence: 99%
“…A P P E N D I X B 2 Flow chart qualitative articles. Identified as eligible: (Bluethmann et al, 2017;Brett et al, 2018;Farias, 2016;Farias et al, 2017;Hackett et al, 2018;Harrow et al, 2014;Humphries et al, 2018;Hurtado-de-Mendoza, Cabling, et al, 2019;Iacorossi et al, 2018;Lambert, Balneaves, Howard, Chia, et al, 2018;Pellegrini et al, 2010;Pieters et al, 2019;Samuel et al, 2017;Toledo et al, 2019;van Londen et al, 2014;Wheeler et al, 2015;Wouters et al, 2013;Yamamoto et al, 2015) A P P E N D I X B 3 Flow chart quantitative articles. Identified as eligible: (Brett et al, 2018b;Cabling et al, 2018;Hagen et al, 2019;Hurtadode-Mendoza, Carrera, et al, 2019;Kroenke et al, 2018;Kuba et al, 2018;Lee & Min, 2018;Yin, Harrell, et al, 2018; Motivation .…”
Objective
Non‐adherence to adjuvant endocrine therapy (AET) for breast cancer leads to increased recurrence and mortality risk and healthcare costs. Evidence on feasible, effective AET adherence interventions is scarce. This paper describes the systematic adaptation of the cost‐effective adherence improving self‐management strategy (AIMS) for patients with HIV to AET for women after breast cancer treatment.
Methods
We followed the intervention mapping protocol for adapting interventions by conducting a needs assessment, reviewing target behaviours and determinants, reassessing behaviour change methods and adapting programme content. Therefore, we performed a literature review, consulted behavioural theory and organised nine advisory board meetings with patients and healthcare professionals.
Results
Non‐adherence occurs frequently among AET users. Compared to HIV treatment, AET is less effective, and AET side effects are more burdensome. This drives AET treatment discontinuation. However, the key determinants of non‐adherence are largely similar to HIV treatment (e.g. motivation, self‐regulation and patient–provider relationship); therefore, most strategies in AIMS‐HIV also seem suitable for AIMS‐AET. Modifications were required, however, regarding supporting patients with coping with side effects and sustaining treatment motivation.
Conclusion
AIMS seems to be a suitable framework for adherence self‐management across conditions and treatments. Intervention mapping offered a transparent, systematic approach to adapting AIMS‐HIV to AET.
“…A systematic review of publications on oral anticancer medications from 2003 to 2015 showed that medication adherence rates varied widely from 46% to 100% [ 7 ]. In interviews with patients with breast cancer, de Mendoza et al [ 8 ] found that 78.9% of the patients failed to report medication discontinuation immediately and 57.9% overreported medication adherence.…”
Background
Medication nonadherence is a costly problem that is common in clinical use and clinical trials alike, with significant adverse consequences. Digital pill systems have proved to be effective and safe solutions to the challenges of nonadherence, with documented success in improving adherence and health outcomes.
Objective
The aim of this human factors validation study is to evaluate a novel digital pill system, the ID-Cap System from etectRx, for usability among patient users in a simulated real-world use environment.
Methods
A total of 17 patients with diverse backgrounds who regularly take oral prescription medications were recruited. After training and a period of training decay, the participants were asked to complete 12 patient-use scenarios during which errors or difficulties were logged. The participants were also interviewed about their experiences with the ID-Cap System.
Results
The participants ranged in age from 27 to 74 years (mean 51 years, SD 13.8 years), and they were heterogeneous in other demographic factors as well, such as education level, handedness, and sex. In this human factors validation study, the patient users completed 97.5% (196/201) of the total use scenarios successfully; 75.1% (151/201) were completed without any failures or errors. The participants found the ID-Cap System easy to use, and they were able to accurately and proficiently record ingestion events using the device.
Conclusions
The participants demonstrated the ability to safely and effectively use the ID-Cap System for its intended use. The ID-Cap System has great potential as a useful tool for encouraging medication adherence and can be easily implemented by patient users.
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