Developing A Text Messaging Intervention To Support Medication Adherence To Endocrine Therapy In Adjuvant Breast Cancer: An Interpretive Description Approach

摘要

Most adjuvant breast cancer patients are prescribed long-term endocrine therapy; however, not all patients continue these medications long term. Text messaging programs have been shown to be a low cost means of increasing medication adherence in a wide variety of chronic conditions, but have not been extensively studied in the breast cancer setting. The primary objective of this study was to develop a text messaging intervention to support long term endocrine therapy adherence. First, we sought to understand the breast cancer survivorship experience in the context of endocrine therapy. Second, we were interested in women's experiences when using a theoretically grounded text messaging intervention. Participants were recruited from a single large academic centre. The initial text messaging intervention was informed by the Medication Adherence Model. Data collection comprised of two semi- structured interviews with eight participants, as well as enrollment in the text messaging intervention. Two main themes arose regarding the experience of breast cancer survivorship. First, fear of recurrence and the worry about returning to normal after breast cancer treatment were dominating emotional experiences. As a result, a high degree of uncertainty permeated their lives, and learning to manage uncertainty was identified as a critical coping skill. When participants were asked regarding preferences for a text messaging intervention, women stated they were interested in an intervention that would act as a supporting friend, sending positive messages about overall wellness. In addition, message tailoring was recognized as an important characteristic in order to increase program usefulness. These findings are useful in shaping future work ensuring long term medication adherence to endocrine therapy.