A secondary data analysis of the GETSET pilot study: the effect of Motivational Interviewing on survivorship in women with hormone receptor positive breast cancer taking adjuvant endocrine therapy

Background: Adjuvant endocrine therapy (ET) is typically recommended to women with hormone receptor positive (HR+) breast cancer for 5-10 years to reduce the risk of recurrence and mortality. At five years, about half of women have discontinued therapy or are non-adherent. Adherence tends to be especially low in Black women and women under 50. The objective of this study was to examine whether participation in a patient-centered counseling intervention affected health-related quality of life (HRQoL), recurrence worry, and treatment related symptoms. Methods: We conducted a single arm pilot study over a 12-month period, consisting of five counselor-led motivational interviewing (MI) counseling sessions. Eligible participants were over 18 years old, English speaking, and had stage I-III HR+ breast cancer. Patient-reported HRQoL and cancer recurrence worry were assessed using survey data collected at baseline and 12-months. Endocrine symptoms were assessed at the 12-month time point, reported descriptively, and age-stratified to examine if symptom burden and age were related. Results: Of the 42 women who initiated the intervention, 35 completed the baseline and 12-month surveys. The majority of participants were over 50 (63%), non-Black and non-Hispanic (63%; 97%). Overall patient-reported anxiety and depression decreased, though only the change in anxiety was statistically significant. Cancer worry increased slightly among participants. The most commonly reported endocrine symptoms were hot flashes, night sweats, vaginal dryness, disinterest in sex, and joint pain, with no significant difference in burden based on age. Conclusions: This study shows early promise in the efficacy of an MI intervention to affect patient-reported HRQoL and treatment-related endocrine symptoms, and reinforces the need for interventions that address the complex barriers to ET use to improve survival and survivorship in this population.