Acceptance and Commitment Therapy to support medication decision-making and quality of life in women with breast cancer: protocol for a pilot randomised controlled trial.

Acceptance and Commitment Therapy Breast cancer Group therapy Medication adherence Pilot Quality of life Remote delivery Video conferencing

Journal

Pilot and feasibility studies
ISSN: 2055-5784
Titre abrégé: Pilot Feasibility Stud
Pays: England
ID NLM: 101676536

Informations de publication

Date de publication:
08 Feb 2022
Historique:
received: 01 07 2021
accepted: 19 01 2022
entrez: 9 2 2022
pubmed: 10 2 2022
medline: 10 2 2022
Statut: epublish

Résumé

Adherence to adjuvant endocrine therapy is affected by medication side-effects and associated distress. Previous interventions focused on educating women to enhance adherence have proved minimally effective. We co-designed an Acceptance and Commitment Therapy (ACT) intervention to enhance medication decision-making and quality of life by targeting a broader range of factors, including side-effect management and psychological flexibility. This study aims to establish key trial parameters, assess the acceptability of the intervention and the extent to which it can be delivered with fidelity, and to demonstrate "proof of principle" regarding its efficacy on primary and process outcomes. The ACTION intervention includes an individual 1:1 ACT session followed by three group sessions involving 8-10 women and two practitioner psychologists. Participants are also provided with access to a website containing evidence-based methods for self-managing side-effects. The ACT sessions were adapted during the COVID-19 pandemic to be remotely delivered via video conferencing software. To evaluate the feasibility and acceptability of this intervention, a multi-site, exploratory, two-arm, individually randomised external pilot trial with a nested qualitative study will be undertaken. Eighty women with early stage breast cancer prescribed adjuvant endocrine therapy will be randomised (1:1) to receive treatment as usual or treatment as usual plus the ACTION intervention. The planned future primary outcome is medication adherence assessed by the ASK-12 measure. Progression to a phase III RCT will be based on criteria related to recruitment and follow-up rates, acceptability to patients, competency and fidelity of delivery, and proof of principle for change in medication adherence. This external pilot trial will be used to ascertain the feasibility of undertaking a future phase III RCT to definitively evaluate an ACT-based intervention to support medication taking behaviour and quality of life in women with early stage breast cancer on adjuvant endocrine therapy. ISRCTN: 12027752. Registered 24 December 2020, https://doi.org/10.1186/ISRCTN12027752.

Sections du résumé

BACKGROUND BACKGROUND
Adherence to adjuvant endocrine therapy is affected by medication side-effects and associated distress. Previous interventions focused on educating women to enhance adherence have proved minimally effective. We co-designed an Acceptance and Commitment Therapy (ACT) intervention to enhance medication decision-making and quality of life by targeting a broader range of factors, including side-effect management and psychological flexibility. This study aims to establish key trial parameters, assess the acceptability of the intervention and the extent to which it can be delivered with fidelity, and to demonstrate "proof of principle" regarding its efficacy on primary and process outcomes.
METHODS METHODS
The ACTION intervention includes an individual 1:1 ACT session followed by three group sessions involving 8-10 women and two practitioner psychologists. Participants are also provided with access to a website containing evidence-based methods for self-managing side-effects. The ACT sessions were adapted during the COVID-19 pandemic to be remotely delivered via video conferencing software. To evaluate the feasibility and acceptability of this intervention, a multi-site, exploratory, two-arm, individually randomised external pilot trial with a nested qualitative study will be undertaken. Eighty women with early stage breast cancer prescribed adjuvant endocrine therapy will be randomised (1:1) to receive treatment as usual or treatment as usual plus the ACTION intervention. The planned future primary outcome is medication adherence assessed by the ASK-12 measure. Progression to a phase III RCT will be based on criteria related to recruitment and follow-up rates, acceptability to patients, competency and fidelity of delivery, and proof of principle for change in medication adherence.
DISCUSSION CONCLUSIONS
This external pilot trial will be used to ascertain the feasibility of undertaking a future phase III RCT to definitively evaluate an ACT-based intervention to support medication taking behaviour and quality of life in women with early stage breast cancer on adjuvant endocrine therapy.
TRIAL REGISTRATION BACKGROUND
ISRCTN: 12027752. Registered 24 December 2020, https://doi.org/10.1186/ISRCTN12027752.

Identifiants

pubmed: 35135619
doi: 10.1186/s40814-022-00985-6
pii: 10.1186/s40814-022-00985-6
pmc: PMC8822728
doi:

Types de publication

Journal Article

Langues

eng

Pagination

33

Subventions

Organisme : Yorkshire Cancer Research
ID : L417
Pays : United Kingdom

Informations de copyright

© 2022. The Author(s).

Références

Arch Intern Med. 2006 May 22;166(10):1092-7
pubmed: 16717171
Ann Oncol. 2018 Feb 1;29(2):504-509
pubmed: 29126161
Ann Oncol. 2016 Oct;27(10):1909-15
pubmed: 27551051
Br J Cancer. 2008 Dec 2;99(11):1763-8
pubmed: 18985046
Pain. 2010 Jul;150(1):173-182
pubmed: 20554116
BMJ. 2016 Oct 24;355:i5239
pubmed: 27777223
Palliat Med. 2017 Feb;31(2):120-129
pubmed: 27412257
J Psychosom Res. 2021 Jan;140:110304
pubmed: 33248396
Am J Surg. 2008 Oct;196(4):500-4
pubmed: 18809051
Clin Breast Cancer. 2016 Aug;16(4):247-255.e3
pubmed: 27133733
J Pain Symptom Manage. 2001 Dec;22(6):979-89
pubmed: 11738160
J Clin Oncol. 2005 Oct 1;23(28):7199-206
pubmed: 16192604
Clin Psychol Rev. 2016 Jun;46:46-58
pubmed: 27176925
Br J Psychiatry. 2002 May;180:461-4
pubmed: 11983645
Br J Cancer. 2013 Sep 3;109(5):1172-80
pubmed: 23949153
Psychooncology. 2004 Nov;13(11):769-78
pubmed: 15386641
JAMA. 1999 Nov 10;282(18):1737-44
pubmed: 10568646
AIDS Care. 2011 Dec;23(12):1660-7
pubmed: 21732897
BMJ Open. 2021 Apr 22;11(4):e049210
pubmed: 33888531
AIDS Care. 2021 Mar;33(3):337-346
pubmed: 32468841
BMJ. 2014 Mar 07;348:g1687
pubmed: 24609605
Menopause. 2015 Feb;22(2):144-54
pubmed: 24983271
Lancet. 2011 Oct 22;378(9801):1461-84
pubmed: 21924486
Front Pharmacol. 2013 Jul 25;4:91
pubmed: 23898295
J Psychosoc Oncol. 2021 Nov 26;:1-18
pubmed: 34825858
Psychooncology. 2019 Feb;28(2):255-263
pubmed: 30511789
Nurs Res. 1993 Mar-Apr;42(2):93-9
pubmed: 8455994
J Clin Oncol. 2010 May 10;28(14):2423-9
pubmed: 20385997
Pilot Feasibility Stud. 2020 Dec 1;6(1):189
pubmed: 33292771
BMC Med Res Methodol. 2013 Aug 20;13:104
pubmed: 23961782
J Eval Clin Pract. 2004 May;10(2):307-12
pubmed: 15189396
Breast Cancer Res Treat. 2019 Feb;173(3):499-510
pubmed: 30387003
Cancer. 2013 Jul 1;119(13):2375-82
pubmed: 23575918
Patient Educ Couns. 2015 May 30;:
pubmed: 26054455
J Clin Oncol. 2016 Jul 20;34(21):2452-9
pubmed: 27217455
Psychooncology. 2013 Feb;22(2):459-64
pubmed: 23382134
Breast Cancer Res Treat. 1999 May;55(2):189-99
pubmed: 10481946
Support Care Cancer. 2016 Jun;24(6):2513-21
pubmed: 26676239
J Am Coll Surg. 2008 Jan;206(1):66-75
pubmed: 18155570
Ann Intern Med. 2013 Feb 5;158(3):200-7
pubmed: 23295957
Pharmacoepidemiol Drug Saf. 2016 Aug;25(8):953-9
pubmed: 27125337
Ann Pharmacother. 2009 Oct;43(10):1621-30
pubmed: 19776298
Br J Cancer. 2013 Apr 16;108(7):1515-24
pubmed: 23519057
Breast Cancer Res Treat. 2008 Jan;107(2):167-80
pubmed: 17876703
Breast Cancer Res Treat. 2012 Jul;134(2):459-78
pubmed: 22689091
J Pain. 2014 Mar;15(3):221-34
pubmed: 24581630
Stat Methods Med Res. 2016 Jun;25(3):1057-73
pubmed: 26092476
Eur J Cancer. 2006 Sep;42(14):2271-6
pubmed: 16644208
Br J Cancer. 2016 Oct 25;115(9):1147-1155
pubmed: 27727232
BMC Musculoskelet Disord. 2015 Jun 16;16:147
pubmed: 26076755
Chron Respir Dis. 2019 Jan-Dec;16:1479973119880893
pubmed: 31569958
J Clin Oncol. 2017 Aug 10;35(23):2666-2673
pubmed: 28661758
Cancer. 2020 Jan 1;126(1):211-218
pubmed: 31539169

Auteurs

Samuel G Smith (SG)

Leeds Institute of Health Science, University of Leeds, Leeds, LS2 9JT, UK. s.smith1@leeds.ac.uk.

Rachel Ellison (R)

Clinical Trials Research Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, LS2 9JT, UK.

Louise Hall (L)

Leeds Institute of Health Science, University of Leeds, Leeds, LS2 9JT, UK.

Jane Clark (J)

Department of Clinical and Health Psychology, St James's University Hospital, Beckett Street, Leeds, LS9 7TF, UK.

Suzanne Hartley (S)

Clinical Trials Research Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, LS2 9JT, UK.

Ellen Mason (E)

Clinical Trials Research Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, LS2 9JT, UK.

Jamie Metherell (J)

Clinical Trials Research Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, LS2 9JT, UK.

Catherine Olivier (C)

Clinical Trials Research Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, LS2 9JT, UK.

Vicky Napp (V)

Clinical Trials Research Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, LS2 9JT, UK.

Jay Naik (J)

Department of Oncology, Harrogate & District Foundation Trust, Park Road, Lancaster, HG2 7SX, UK.

Sarah Buckley (S)

Department of Clinical Research, Mid Yorkshire Hospitals NHS Trust, Aberford Road, Wakefield, WF1 4AL, UK.

Charlotte Hirst (C)

Department of Clinical Research, Mid Yorkshire Hospitals NHS Trust, Aberford Road, Wakefield, WF1 4AL, UK.

Sue Hartup (S)

St James's University Hospital, Beckett Street, Leeds, LS9 7TF, UK.

Richard D Neal (RD)

Leeds Institute of Health Science, University of Leeds, Leeds, LS2 9JT, UK.

Galina Velikova (G)

St James's University Hospital, Beckett Street, Leeds, LS9 7TF, UK.

Amanda Farrin (A)

Clinical Trials Research Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, LS2 9JT, UK.

Michelle Collinson (M)

Clinical Trials Research Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, LS2 9JT, UK.

Christopher D Graham (CD)

Department of Psychology, Queen's University Belfast, Belfast, BT7 1NN, UK.

Classifications MeSH