The Technology Enhanced Navigation (TEN) Trial among low-income patients with breast cancer.

Helzlsouer, Kathy J.; Appling, Susan; Scarvalone, Susan; Manocheh, Shannon; Gallicchio, Lisa; MacDonald, Ryan; Henninger, Dawn E.; Varanasi, Arti

doi:10.1200/jco.2015.33.15_suppl.6500

Cited by 2 publications

(7 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Four studies that included AET prescription initiation but not persistence or compliance were excluded from the meta-analysis to allow for a comparison of adherence over time. [16][17][18][19] If the manuscript contained insufficient data to calculate an OR, we contacted the authors to request it and included the estimate if the data were provided. Of the 33 studies identified for the systematic review, 25 were included in the meta-analysis (Fig 1).…”

Section: Meta-analytic Statistical Approachmentioning

confidence: 99%

“…Most of the studies (n 5 22) used dichotomous measures of adherence, with participants considered adherent if they received (confirmed via prescription records) or took (confirmed via electronic monitoring or self-report) ≥80% of the medication as prescribed during the study period. [16][17][18][19][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38] Comparatively few studies (n 5 8) used continuous measures of adherence. [39][40][41][42][43][44][45][46] Studies collected adherence data in various ways including self-report, medical chart records, prescription records, health insurance claims, electronic monitoring devices, and biological assays (urine or blood).…”

Section: Adherence Measurementmentioning

confidence: 99%

“…Approximately half of the studies (n 5 15) intervened early in patients' treatment trajectories, either at prescription initiation 16,17,[23][24][25][26]30,[36][37][38]43 or in the first year and a half of adjuvant treatment. 28,34,40,47 Four of these studies examined only AET initiation.…”

Section: Timingmentioning

confidence: 99%

“…28,34,40,47 Four of these studies examined only AET initiation. [16][17][18][19] Fifteen studies included women across the full trajectory of adjuvant treatment (0-51 years). 22,27,29,32,33,35,39,41,42,[44][45][46][48][49][50] One study included patients who had taken 4-5 years of tamoxifen at baseline and were eligible to continue with letrozole, 19 and two studies did not report any information regarding how long women had been taking AET.…”

Section: Timingmentioning

confidence: 99%

“…implementing cultural adaptations to the focal interventions to promote adherence, apart from changing the language of the intervention. The delivery language of the interventions varied by target audience; English was the most common 17,19,24,27,29,30,34,39,[43][44][45][46]49 and five were offered in multiple languages including English. 16,18,28,35,36…”

Section: Cultural Tailoring Of Interventionsmentioning

confidence: 99%

See 4 more Smart Citations

A Systematic Review and Meta-Analysis of Interventions to Promote Adjuvant Endocrine Therapy Adherence Among Breast Cancer Survivors

Bright

Finkelstein

Nealis

et al. 2023

JCO

View full text Add to dashboard Cite

PURPOSE Adjuvant endocrine therapy (AET) adherence among breast cancer survivors is often suboptimal, leading to higher cancer recurrence and mortality. Intervention studies to promote AET adherence have burgeoned, more than doubling in number since this literature was last reviewed. The current aim is to provide an up-to-date systematic review and meta-analysis of interventions to enhance AET adherence and to identify strengths and limitations of existing interventions to inform future research and clinical care. METHODS Systematic searches were conducted in three electronic databases. Studies were included in the systematic review if they examined an intervention for promoting AET adherence among breast cancer survivors. Studies were further included in the meta-analyses if they examined a measure of AET adherence (defined as compliance or persistence beyond initiation) and reported (or provided upon request) sufficient information to calculate an effect size. RESULTS Of 5,045 unique records, 33 unique studies representing 375,951 women met inclusion criteria for the systematic review. Interventions that educated patients about how to manage side effects generally failed to improve AET adherence, whereas policy changes that lowered AET costs consistently improved adherence. Medication reminders, communication, and psychological/coping strategies showed varied efficacy. Of the 33 studies that met the inclusion criteria for the systematic review, 25 studies representing 367,873 women met inclusion criteria for the meta-analysis. The meta-analysis showed statistically significant effects of the adherence interventions overall relative to study-specified control conditions (number of studies [k] = 25; odds ratio, 1.412; 95% CI, 1.183 to 1.682; P = .0001). Subgroup analyses showed that there were no statistically significant differences in effect sizes by study design (randomized controlled trial v other), publication year, directionality of the intervention (unidirectional v bidirectional contact), or intervention type. CONCLUSION To our knowledge, this is the first known meta-analysis to demonstrate a significant effect for interventions to promote AET adherence. The systematic review revealed that lowering medication costs and a subgroup of psychosocial and reminder interventions showed the most promise, informing future research, policy, and clinical directions.

show abstract

Section: Meta-analytic Statistical Approachmentioning

confidence: 99%

Section: Adherence Measurementmentioning

confidence: 99%

Section: Timingmentioning

confidence: 99%

Section: Timingmentioning

confidence: 99%

Section: Cultural Tailoring Of Interventionsmentioning

confidence: 99%

See 3 more Smart Citations

A Systematic Review and Meta-Analysis of Interventions to Promote Adjuvant Endocrine Therapy Adherence Among Breast Cancer Survivors

Bright

Finkelstein

Nealis

et al. 2023

JCO

View full text Add to dashboard Cite

show abstract

Effectiveness of Digital Counseling Environments on Anxiety, Depression, and Adherence to Treatment Among Patients Who Are Chronically Ill: Systematic Review (Preprint)

Paalimäki-Paakki¹,

Virtanen²,

Henner³

et al. 2021

Preprint

View full text Add to dashboard Cite

BACKGROUND Patients who are chronically ill need novel patient counseling methods to support their self-care at different stages of the disease. At present, knowledge of how effective digital counseling is at managing patients’ anxiety, depression, and adherence to treatment seems to be fragmented, and the development of digital counseling will require a more comprehensive view of this subset of interventions. OBJECTIVE This study aims to identify and synthesize the best available evidence on the effectiveness of digital counseling environments at improving anxiety, depression, and adherence to treatment among patients who are chronically ill. METHODS Systematic searches of the EBSCO (CINAHL), PubMed, Scopus, and Web of Science databases were conducted in May 2019 and complemented in October 2020. The review considered studies that included adult patients aged ≥18 years with chronic diseases; interventions evaluating digital (mobile, web-based, and ubiquitous) counseling interventions; and anxiety, depression, and adherence to treatment, including clinical indicators related to adherence to treatment, as outcomes. Methodological quality was assessed using the standardized Joanna Briggs Institute critical appraisal tool for randomized controlled trials or quasi-experimental studies. As a meta-analysis could not be conducted because of considerable heterogeneity in the reported outcomes, narrative synthesis was used to synthesize the results. RESULTS Of the 2056 records screened, 20 (0.97%) randomized controlled trials, 4 (0.19%) pilot randomized controlled trials, and 2 (0.09%) quasi-experimental studies were included. Among the 26 included studies, 10 (38%) digital, web-based interventions yielded significantly positive effects on anxiety, depression, adherence to treatment, and the clinical indicators related to adherence to treatment, and another 18 (69%) studies reported positive, albeit statistically nonsignificant, changes among patients who were chronically ill. The results indicate that an effective digital counseling environment comprises high-quality educational materials that are enriched with multimedia elements and activities that engage the participant in self-care. Because of the methodological heterogeneity of the included studies, it is impossible to determine which type of digital intervention is the most effective for managing anxiety, depression, and adherence to treatment. CONCLUSIONS This study provides compelling evidence that digital, web-based counseling environments for patients who are chronically ill are more effective than, or at least comparable to, standard counseling methods; this suggests that digital environments could complement standard counseling.

show abstract

The Technology Enhanced Navigation (TEN) Trial among low-income patients with breast cancer.

Cited by 2 publications

References 0 publications

A Systematic Review and Meta-Analysis of Interventions to Promote Adjuvant Endocrine Therapy Adherence Among Breast Cancer Survivors

A Systematic Review and Meta-Analysis of Interventions to Promote Adjuvant Endocrine Therapy Adherence Among Breast Cancer Survivors

Effectiveness of Digital Counseling Environments on Anxiety, Depression, and Adherence to Treatment Among Patients Who Are Chronically Ill: Systematic Review (Preprint)

Contact Info

Product

Resources

About