Telephone-based motivational interviewing consultations to enhance adherence to adjuvant endocrine therapy: A qualitative study on the experiences of women with non-metastatic breast cancer

Background/Purpose: Daily adjuvant endocrine therapy (AET) is prescribed to women for 5–10 years for hormone-sensitive breast cancer (60%–75% of breast cancer cases) to prevent recurrence and reduce mortality. However, a significant number of women experience AET-related issues that may affect quality of life and AET adherence. Few interventions to enhance AET adherence have been developed and tested, and the few studies available to date have generally produced inconclusive results. A telephone consultation program about AET using motivational interviewing (MI) principles was developed to be delivered by nurse navigators. This study aimed to describe women's experiences and perceived impact of this supportive program. Methods: 20 women who were first prescribed AET for nonmetastatic breast cancer in the last 5 years and who self-reported AET issues were provided with at least 2 individual, telephone-based MI consultations. Following the last MI consultation, we conducted a qualitative study. Participants were interviewed by a research team member about their experiences and perceptions using a semi-structured interview guide. Interviews were audio-taped, transcribed verbatim, and analyzed using thematic analysis. Results: Four key themes emerged from the analysis. The program was described by participants as: (1) a person-centered cancer care experience; (2) providing key information for self-management; (3) supportive regarding AET side effect management and adherence; and (4) contributing to a more optimistic perspective on AET. Overall, consultations via telephone were considered as convenient by most participants. Conclusions and Implications: Findings suggest that a telephone-based MI program can enhance side-effect management, motivation and adherence among women with non-metastatic breast cancer who have an AET. Ultimately, the program can better equip women to cope with AET in a less distressing and more optimistic manner. Future work would rely on quantitative approach to assess more broadly these findings.