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Provider perspectives on patient-provider communication for adjuvant endocrine therapy symptom management

Supportive Care in Cancer volume 25, pages 1055–1061 (2017)Cite this article

Abstract

Purpose

Providers’ communication skills play a key role in encouraging breast cancer survivors to report symptoms and adhere to long-term treatments such as adjuvant endocrine therapy (AET). The purpose of this study was to examine provider perspectives on patient-provider communication regarding AET symptom management and to explore whether provider perspectives vary across the multi-disciplinary team of providers involved in survivorship care.

Methods

We conducted three one-hour focus groups with a multi-disciplinary group of health care providers including oncology specialists, primary care physicians, and non-physician providers experienced in caring for breast cancer survivors undergoing AET (n = 13). Themes were organized using Epstein and Street’s (2007) Framework for Patient-Centered Communication in Cancer Care.

Results

The findings of this study suggest providers’ communication behaviors including managing survivors’ uncertainty, responding to survivors’ emotions, exchanging information, and enabling self-management influences the quality of patient-provider communication about AET symptoms. Additionally, lack of systematic symptom assessment tools for AET requires providers to use discretion in determining which symptoms to discuss with survivors resulting in approaches that vary based on providers’ discipline.

Conclusion

There may be AET-specific provider communication skills and behaviors that promote effective patient-provider communication but additional research is needed to identify practices and policies that encourage these skills and behaviors among the many providers involved in survivorship care. Efforts are also needed to coordinate AET symptom assessment across providers, clarify providers’ roles in symptom assessment, and determine best practices for AET symptom communication.

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Author information

Affiliations

  1. Department of Health Policy and Management, University of North Carolina at Chapel Hill, Gillings School of Global Public Health, 1105F McGavran-Greenberg Hall, CB#7411, Chapel Hill, NC, USA

    Kea Turner & Cleo A Samuel

  2. Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, 450 West Drive, Chapel Hill, NC, USA

    Cleo A Samuel

  3. University of Pittsburgh Medical Center Cancer Center, School of Nursing, University of Pittsburgh, 415 Victoria Building, 3500 Victoria Street, Pittsburgh, PA, USA

    Heidi AS Donovan

  4. University of Pittsburgh Medical Center Health Plan, University of Pittsburgh, 600 Grant Street, Pittsburgh, PA, USA

    Ellen Beckjord & Alexandra Cardy

  5. Departments of Psychiatry, Psychology, Epidemiology, Biostatistics, and Clinical and Translational Science, University of Pittsburgh, 3811 O’Hara Street, Pittsburgh, PA, USA

    Mary Amanda Dew

  6. Department of Medicine, University of Pittsburgh, A. 140 Cooper Pavilion, 5115 Centre Avenue, Pittsburgh, PA, USA

    GJ van Londen

Authors
  1. Kea Turner
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  2. Cleo A Samuel
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  3. Heidi AS Donovan
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  4. Ellen Beckjord
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  5. Alexandra Cardy
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  6. Mary Amanda Dew
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  7. GJ van Londen
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Corresponding author

Correspondence to Kea Turner.

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Conflict of interest statement

We wish to confirm that there are no known conflicts of interest associated with this publication and there has been no significant financial support for this work that could have influenced its outcome.

We wish to confirm that we have ownership over the primary data used in this manuscript and give permission to Supportive Care in Cancer to review the data if needed.

Funding

American Federation for Aging Research/John A. Hartford Foundation, the Magee-Women’s Research Institute and Foundation, the University of Pittsburgh Multidisciplinary Clinical Research Scholars Program–National Institutes of Health Clinical and Translational Science Award(CTSA)(05 KL2 RR024154), the National Cancer Institute Cancer Center Support Grant (P30 CA047904), and the National Cancer Institute Award Diversity Supplement Award (3 R01 CA150980-04S1).

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Turner, K., Samuel, C.A., Donovan, H.A. et al. Provider perspectives on patient-provider communication for adjuvant endocrine therapy symptom management. Support Care Cancer 25, 1055–1061 (2017). https://doi.org/10.1007/s00520-016-3491-9

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Keywords

  • Patient-provider communication
  • Breast cancer
  • Adjuvant endocrine therapy
  • Aromatase inhibitors
  • Symptom management
  • Patient-centered communication