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Long-term endocrine therapy adherence following stress management for breast cancer

乳腺癌压力管理后长期坚持内分泌治疗

基本信息

批准号：
10246179
负责人：
Molly Elise Ream
金额：
$ 4.2万
依托单位：
UNIVERSITY OF MIAMI CORAL GABLES
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-09-01 至 2022-09-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10246179
关键词：
Adherence Affect Anxiety Attention Behavioral Breast Cancer Patient Clinical Clinical Oncology Cognitive Cognitive Therapy Computerized Medical Record Data Data Collection Data Reporting Diagnosis Disease Distress Educational Intervention Face Goals Health Health education Hormone Receptor Hot flushes Incidence Intervention Life Linear Models Literature Long-Term Effects Longterm Follow-up Malignant Neoplasms Measures Mediating Mediation Mediator of activation protein Menopause Mental Depression Methods Mission Moods Nonmetastatic Oncology Operative Surgical Procedures Outcome Patient Self-Report Pharmaceutical Preparations Pharmacy facility Physiological Adaptation Process Protocols documentation Psychosocial Assessment and Care Randomized Controlled Trials Records Recurrence Relaxation Therapy Research Research Personnel Risk Role Running Savings Science Sleeplessness Social support Stress Testing Therapeutic Intervention Time Training Training and Education United States Well in self Woman Work adjuvant endocrine therapy base breast cancer diagnosis cohort coping depressive symptoms effective therapy experience follow-up group intervention hormone receptor-positive hormone therapy improved intervention effect malignant breast neoplasm medication compliance mortality prognostic psychologic psychological distress psychosocial side effect skills statistics stress management survivorship therapy adherence tumor

项目摘要

PROJECT SUMMARY Background. In the United States, 1 in 8 women will be diagnosed with breast cancer in their lifetime, with 1 in 39 women dying from the disease. While breast cancer is highly prevalent and can be deadly, in many cases it is treatable. Adjuvant endocrine therapy (AET) is an effective treatment for the 80% of women with early-stage disease who have hormone receptors expressed in their breast cancer. Although women who complete the recommended 10-year course of AET and consistently take the medication have a significantly reduced chance of recurrence, approximately half of women fail to complete this course of treatment. In addition to coping with debilitating menopausal-related side effects, women with breast cancer face psychosocial barriers that have been associated with poor AET adherence, including anxiety, depression, and poor social support. Importantly, these are modifiable constructs that may contribute to adherence and can be targeted by psychosocial interventions. Research Strategy. The current study aims to 1) test the long-term effects of two brief post-surgical psychosocial interventions, cognitive behavioral therapy (CBT) and Relaxation Training (RT), versus an attention-matched Health Education (HE) control (not focused on medication adherence), on AET adherence at 7 years post-baseline, 2) examine psychosocial mediators of trial effects on AET adherence, and 3) examine whether trial condition and AET adherence are related to 8-14-year recurrence- free survival. I have a unique opportunity to take advantage of an ongoing long-term follow-up from a cohort of women who participated in a randomized controlled trial for 5-week stress management and add measures to assess their adherence to AET and recurrence-free survival. Significance. Our prior work has demonstrated that CBT and RT effectively improved depressive affect, emotional well-being, and stress management skills in the intervention groups in comparison to those receiving the HE control. Given evidence that psychological distress relates to worse AET adherence, it is plausible that women receiving the intervention have had improvements in their AET adherence as a downstream effect of improvements in psychological wellbeing. This study will be the first to test whether a stress management intervention delivered post-surgery may have a long-term impact on AET adherence. If we can facilitate AET adherence early in the disease process through psychological intervention, we may ultimately improve long-term health outcomes. Training Plan. With additional training and experience in statistics, psycho-oncology, and adherence science, this study will lay the groundwork for my goal to become an independent clinical researcher. In line with the NCI’s mission of improving survivorship and helping people live longer, healthier lives, my long-term goals are to elucidate the behavioral processes underlying the effects of stress on cancer outcomes and to target these processes through psychosocial interventions that are feasible in clinical oncology settings.

项目总结