Acceptability of Four Intervention Components Supporting Medication Adherence in Women with Breast Cancer: a Process Evaluation of a Fractional Factorial Pilot Optimization Trial.
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All Authors
Green, SMC.
Rousseau, N.
Hall, LH.
French, DP.
Graham, CD.
Lloyd, KE.
Collinson, M.
Ow, PL.
Taylor, C.
Howdon, D.
LTHT Author
Green, Sophie
Clark, Jane
Parbutt, Catherine
Buxton, Jacqueline
Moore, Sally
Velikova, Galina
Clark, Jane
Parbutt, Catherine
Buxton, Jacqueline
Moore, Sally
Velikova, Galina
LTHT Department
Clinical & Health Psychology
Medicines Management & Pharmacy Services
Leeds Cancer Centre
Medicines Management & Pharmacy Services
Leeds Cancer Centre
Non Medic
Consultant Pharmacist
Research Nurse
Research Nurse
Publication Date
2024
Item Type
Journal Article
Randomized Controlled Trial
Randomized Controlled Trial
Language
Subject
Subject Headings
Abstract
Adjuvant endocrine therapy (AET) reduces mortality in early-stage breast cancer, but adherence is low. We developed a multicomponent intervention to support AET adherence comprising: text messages, information leaflet, acceptance and commitment therapy (ACT), and side-effect website. Guided by the multiphase optimization strategy, the intervention components were tested in the ROSETA pilot optimization trial. Our mixed-methods process evaluation investigated component acceptability. The pilot optimization trial used a 24-1 fractional factorial design. Fifty-two women prescribed AET were randomized to one of eight experimental conditions, containing unique component combinations. An acceptability questionnaire was administered 4 months post-randomization, and semi-structured interviews with 20 participants further explored acceptability. Assessments were guided by four constructs of the theoretical framework of acceptability: affective attitude, burden, perceived effectiveness, and coherence. Quantitative and qualitative findings were triangulated to identify agreements/disagreements. There were high overall acceptability scores (median = 14-15/20, range = 11-20). There was agreement between the qualitative and quantitative findings when triangulated. Most participants "liked" or "strongly liked" all components and reported they required low effort to engage in. Between 50% (leaflet) and 65% (SMS) "agreed" or "strongly agreed," it was clear how each component would help adherence. Perceived effectiveness was mixed, with 35.0% (text messages) to 55.6% (ACT) of participants "agreeing" or "strongly agreeing" that each component would improve their adherence. Interview data provided suggestions for improvements. The four components were acceptable to women with breast cancer and will be refined. Mixed-methods and triangulation were useful methodological approaches and could be applied in other optimization trial process evaluations.
Journal
Prevention Science