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Both “Vitamin L for Life” and “One Milligram of Satan”: A Multi-Perspective Qualitative Exploration of Adjuvant Endocrine Therapy Use after Breast Cancer

1
Department of Psychology, University of Calgary, Calgary, AB T2N 1N4, Canada
2
Division of Psychosocial Oncology, Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
3
Faculty of Nursing, University of Calgary, Calgary, AB T2N 1N4, Canada
4
Department of Psychology, Memorial University of Newfoundland, St. John’s, NL A1C 5S7, Canada
*
Authors to whom correspondence should be addressed.
Shared senior authorship.
Curr. Oncol. 2021, 28(4), 2496-2515; https://doi.org/10.3390/curroncol28040227
Received: 4 June 2021 / Revised: 1 July 2021 / Accepted: 2 July 2021 / Published: 5 July 2021
Adjuvant endocrine therapy (AET) is recommended after hormone receptor-positive breast cancer to reduce risk of recurrence, but adherence is sub-optimal in many women. Behavioral interventions have been ineffective in improving adherence rates to AET. This qualitative descriptive study investigates factors that support women in AET use and suggestions for interventions to improve AET use and management. Interviews with women who persisted with AET (n = 23), women who discontinued AET (n = 15), and healthcare providers (HCPs; oncologists, oncology residents, and pharmacists; n = 9) were conducted, transcribed, and described using thematic analysis. Data collection stopped once saturation occurred (i.e., no new codes or themes emerged during interviews). Two researchers created codes and developed themes in an iterative process; a third researcher verified the representativeness of final themes. This study was approved by the Health Research Ethics Board of Alberta (ID: HREBA.CC-17-0513). Women who persisted described being prepared for side effects and having self-management strategies, strong rationale for AET use, supportive HCPs, and available resources as relevant factors. Women who discontinued described feeling overwhelmed by side effects, information needs, drawbacks of AET, helpful/unhelpful experiences with HCPs, and contextual factors as relevant to their discontinuation. HCPs described health system-related and patient-related barriers, side effect management, and patient-provider interactions as relevant to supporting AET use. The considerable overlap in themes among the three groups suggests broad recognition of salient factors relevant to AET use and that associated strategies to improve use may be acceptable to patients and providers alike. Factors supporting AET use could include the following: education (which may be necessary but insufficient), developing a strong personal rationale for use, being prepared for side effects, having side effect management strategies, reciprocal communication between patients and HCPs, and accessible resources. View Full-Text
Keywords: qualitative; breast cancer; persistence; adjuvant endocrine therapy qualitative; breast cancer; persistence; adjuvant endocrine therapy
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MDPI and ACS Style

Toivonen, K.I.; Oberoi, D.; King-Shier, K.; Piedalue, K.-A.L.; Rash, J.A.; Carlson, L.E.; Campbell, T.S. Both “Vitamin L for Life” and “One Milligram of Satan”: A Multi-Perspective Qualitative Exploration of Adjuvant Endocrine Therapy Use after Breast Cancer. Curr. Oncol. 2021, 28, 2496-2515. https://doi.org/10.3390/curroncol28040227

AMA Style

Toivonen KI, Oberoi D, King-Shier K, Piedalue K-AL, Rash JA, Carlson LE, Campbell TS. Both “Vitamin L for Life” and “One Milligram of Satan”: A Multi-Perspective Qualitative Exploration of Adjuvant Endocrine Therapy Use after Breast Cancer. Current Oncology. 2021; 28(4):2496-2515. https://doi.org/10.3390/curroncol28040227

Chicago/Turabian Style

Toivonen, Kirsti I., Devesh Oberoi, Kathryn King-Shier, Katherine-Ann L. Piedalue, Joshua A. Rash, Linda E. Carlson, and Tavis S. Campbell 2021. "Both “Vitamin L for Life” and “One Milligram of Satan”: A Multi-Perspective Qualitative Exploration of Adjuvant Endocrine Therapy Use after Breast Cancer" Current Oncology 28, no. 4: 2496-2515. https://doi.org/10.3390/curroncol28040227

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