Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA.
BMJ Open. 2021 Jan 4;11(1):e041626. doi: 10.1136/bmjopen-2020-041626.
Patient adherence to adjuvant endocrine therapy (AET) after a diagnosis of hormone-sensitive breast cancer is poor. Previous interventions have failed to produce changes in adherence, address patient preferences or include theoretically informed and evidence-based components. Therefore, we iteratively developed a patient-centred, evidence-based, small-group, videoconference intervention to improve adherence and symptom management as well as reduce distress for patients taking AET after breast cancer (Symptom-Targeted Randomised Intervention for Distress and Adherence to Adjuvant Endocrine Therapy, STRIDE).
The current study is a non-blinded, randomised, controlled, feasibility trial of STRIDE compared with a medication monitoring control group. The primary objective is to examine the feasibility and acceptability of STRIDE, while secondary objectives are to assess changes in objective and subjective adherence, symptom distress and satisfaction with AET. Patients will be recruited from the Massachusetts General Hospital Cancer Center in Boston, Massachusetts. The total number of patients accrued will be 75, with ≥60 patients completing the study. All patients will store their AET in an electronic pill bottle for objective adherence monitoring. Patients randomly assigned to the STRIDE intervention will receive 6 weekly 1-hour sessions, in small groups of two, delivered via videoconferencing by a trained mental health professional. Patients assigned to the control group will store their medication in the electronic pill bottle and receive follow-up oncology care as usual. All participants will complete self-report psychosocial measures at baseline, 12 weeks and 24 weeks postbaseline.
The study is funded by the National Cancer Institute of the National Institutes of Health and is approved by the Dana-Farber/Harvard Cancer Center Institutional Review Board (Protocol #18-603, V.1.2, first approval date 1 February 2019). The study will be reported in accordance with the Consolidated Standards of Reporting Trials statement for non-pharmacological trials. Results will be published in peer-reviewed academic journals, presented at scientific meetings and disseminated to patient organisations and media outlets.NCT03837496; Pre-results.
激素敏感型乳腺癌患者在诊断后接受辅助内分泌治疗(AET)的依从性较差。以前的干预措施未能改变患者的依从性,也没有考虑到患者的偏好,或者包括理论上的知情和循证成分。因此,我们反复开发了一种以患者为中心、基于证据的小群体视频会议干预措施,以改善接受乳腺癌 AET 治疗后的患者的依从性和症状管理,并减轻他们的痛苦(针对症状的辅助内分泌治疗依从性和困扰的随机干预,STRIDE)。
本研究是 STRIDE 与药物监测对照组的非盲、随机、对照、可行性试验。主要目的是检验 STRIDE 的可行性和可接受性,次要目的是评估客观和主观依从性、症状困扰和对 AET 的满意度的变化。患者将从马萨诸塞州波士顿的马萨诸塞州综合医院癌症中心招募。入组患者总数为 75 例,≥60 例患者完成研究。所有患者将使用电子药瓶储存 AET,进行客观依从性监测。随机分配到 STRIDE 干预组的患者将接受 6 周每周 1 小时的小组课程,由经过培训的心理健康专业人员通过视频会议进行。分配到对照组的患者将在电子药瓶中储存他们的药物,并接受常规的肿瘤学随访。所有参与者将在基线、12 周和 24 周后完成自我报告的心理社会测量。
该研究由美国国立卫生研究院国家癌症研究所资助,并得到达纳-法伯/哈佛癌症中心机构审查委员会的批准(协议 #18-603,V.1.2,首次批准日期 2019 年 2 月 1 日)。该研究将按照非药物试验的统一报告标准进行报告。结果将发表在同行评议的学术期刊上,在科学会议上展示,并分发给患者组织和媒体。NCT03837496;预结果。