Abstract:
Nurse led telephone follow up (NLTFU) for women taking adjuvant endocrine therapy (AET) was introduced at Auckland City Hospital as a solution to capacity and demand shortfall caused by an increased incidence of breast cancer and improvements in survival. This clinic focuses on tolerability and adherence to treatment as non−adherence is a substantial problem that threatens the efficacy of AET and reduces breast cancer outcomes. Patient satisfaction is a reliable indicator of whether a service is meeting the needs and expectations of patients and there is evidence of both high satisfaction with NLTFU and an association between satisfaction and adherence however this literature is not available for AET. The current study explored the relationship between satisfaction and adherence to treatment in 36 women who had received NLTFU for the first six months of AET. Using a postal questionnaire with a 54% response rate this study established an adherence rate of 77% and discontinuation of 14%. A relationship between treatment satisfaction and adherence was clearly demonstrated and the presence of side effects was found to reduce treatment satisfaction in all domains of the Treatment Satisfaction Questionnaire for Medication (TSQM). No relationship was seen between side effects and adherence or satisfaction with care and adherence although all patients who discontinued treatment did so due to side effects. Treatment satisfaction was highest in the effectiveness and global satisfaction domain of TSQM suggesting that women may be more willing to tolerate side effects if they are satisfied that AET will prevent breast cancer recurrence. Future initiatives need to build on the foundations of the NLTFU clinic to create a patient centred model of follow up care for patients receiving AET within the Auckland Region.
