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Development and Refinement of a Telehealth Intervention for Symptom Management, Distress, and Adherence to Adjuvant Endocrine Therapy after Breast Cancer

Journal of Clinical Psychology in Medical Settings volume 28, pages 603–618 (2021)Cite this article

Abstract

Adjuvant endocrine therapy (AET) prevents recurrence after early stage, hormone sensitive breast cancer; however, adherence to AET is suboptimal, and efficacious interventions are severely lacking. Barriers to adherence are well established; however, interventions, thus, far have failed to produce meaningful changes in adherence and have generally not followed guiding principles of psychosocial intervention development. The purpose of this paper is to describe the iterative development, using the National Institutes of Health Stage Model for Behavioral Intervention Development, of an evidence-based, patient-centered, telehealth intervention to enhance adherence, improve symptom management, and reduce distress for patients taking AET after breast cancer, with a focus on (1) a small open pilot study which informed modifications and refinement of the intervention based on quantitative and qualitative patient feedback about feasibility and acceptability and (2) the underlying theoretical and empirical rationale for each component of the finalized intervention. Clinical implications and directions for future research are discussed.

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Acknowledgements

We thank the study patients for their time and dedication to this research study.

Funding

This study was funded by a Career Development Award from the National Cancer Institute of the National Institutes of Health (K07CA211107; Jacobs).

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Affiliations

  1. Department of Psychiatry, Massachusetts General Hospital, 55 Fruit Street, Yawkey, Suite 10B, Boston, MA, 02114, USA

    Jamie M. Jacobs, Emily A. Walsh, Chelsea S. Rapoport, Elyse R. Park, Kathryn Post & Joseph A. Greer

  2. Department of Psychiatry, Harvard Medical School, Boston, MA, USA

    Jamie M. Jacobs, Elyse R. Park, Kathryn Post & Joseph A. Greer

  3. Department of Psychology, University of Miami, Coral Gables, FL, USA

    Emily A. Walsh, Michael H. Antoni & Steven A. Safren

  4. Department of Medicine, Massachusetts General Hospital, Boston, MA, USA

    Amy Comander, Jeffrey Peppercorn & Jennifer S. Temel

  5. Department of Medicine, Harvard Medical School, Boston, MA, USA

    Amy Comander, Jeffrey Peppercorn & Jennifer S. Temel

Authors
  1. Jamie M. Jacobs
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  2. Emily A. Walsh
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  3. Chelsea S. Rapoport
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  4. Michael H. Antoni
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  5. Elyse R. Park
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  6. Kathryn Post
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  7. Amy Comander
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  8. Jeffrey Peppercorn
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  9. Steven A. Safren
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  10. Jennifer S. Temel
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  11. Joseph A. Greer
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by JJ, EW, and CR. The first draft of the manuscript was written by JJ and all authors revised previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Jamie M. Jacobs.

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Conflict of interest

MA receives a small royalty from a book and related treatment manuals on stress management in breast cancer. JG receives royalties from Springer Humana Press, has research funding from Gaido Health/BCG Digital Ventures, and is a paid consultant from Concerto HealthAI. JP has received research funding from Pfizer, is a paid consultant for Athenex, and JP’s spouse is an employee of GlaxoSmithKline. All other authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of Dana-Farber/Harvard Cancer Center Institutional Review Board and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. All patients signed informed consent with trained study staff.

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Jacobs, J.M., Walsh, E.A., Rapoport, C.S. et al. Development and Refinement of a Telehealth Intervention for Symptom Management, Distress, and Adherence to Adjuvant Endocrine Therapy after Breast Cancer. J Clin Psychol Med Settings 28, 603–618 (2021). https://doi.org/10.1007/s10880-020-09750-4

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  • DOI: https://doi.org/10.1007/s10880-020-09750-4

Keywords

  • Hormonal therapy
  • Breast cancer
  • Symptom management
  • Adherence
  • Distress
  • Cognitive-behavioral intervention