Abstract
ObjectiveUp to 50% of women prescribed tamoxifen do not take it as prescribed for the full duration, which increases risk of recurrence and mortality. The current paper describes the development of a self-management intervention aiming to improve adherence in breast cancer survivors taking tamoxifen.MethodsThe intervention was developed following an Intervention Mapping approach. The content of the intervention was determined by theories of health behaviour and empirical evidence. Development was an iterative process involving input from expert researchers, clinicians and patient representatives.ResultsThe intervention was designed to improve both intentional and unintentional non-adherence. Key features included modifying unhelpful illness and treatment beliefs, improving confidence for coping with side effects and developing strategies for remembering to take tamoxifen.ConclusionIntervention Mapping proved a useful tool for developing an intervention which is grounded in theory and empirical evidence. The intervention has the potential to improve adherence in breast cancer survivors but needs to be trialled before the effectiveness of the intervention can be determined.
Highlights
Women with oestrogen receptor positive early breast cancer are prescribed hormone therapy (HT) such as tamoxifen for up to 10 years post primary treatment in order to reduce the risk of cancer recurrence
Recent research has highlighted the utility of illness perceptions, defined as the beliefs that patients hold about their illness, in understanding nonadherence to tamoxifen
Women who reported via the Illness Perceptions Questionnaire for Breast Cancer Survivors (IPQ-BCS; [26]) higher consequences of taking tamoxifen and who thought that their likelihood of cancer recurrence was low were more likely to be nonadherent
Summary
The intervention was developed following an Intervention Mapping approach. The content of the intervention was determined by theories of health behaviour and empirical evidence. Development was an iterative process involving input from expert researchers, clinicians and patient representatives
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