title: Exploring the role of physician communication about adjuvant endocrine therapy among breast cancer patients on active treatment: a qualitative analysis.
abstract: To better understand how physicians communicate with breast cancer patients about adjuvant endocrine therapy (AET), we explored, from the breast cancer patient's perspective, dimensions of the patient-provider communication among women who were on active AET treatment.
  
  
  
  Qualitative methods using semi-structured in-depth interviews were conducted with breast cancer patients (n = 22) who filled a prescription for AET in the previous 12 months. Interview questions aimed to elicit experiences with AET. We reviewed and coded interview transcripts using qualitative principles of inductive reasoning to identify concepts and themes from interview data.
  
  
  
  We grouped emergent themes into four major functions of physician-patient communication: (1) information exchange, (2) decision-making to take and continue AET, (3) enabling patient self-management and monitoring potential side effects, and (4) emotional support. Physicians exchanged information with patients in a way that they understood and enhanced patient's health literacy regarding the benefits and knowledge of AET. Physicians empowered patients to make decisions about their care. Patients expressed trust and confidence in their physician which helped them seek care when needed. Patients reported a high degree of self-efficacy to self-manage AET and were continuing treatment despite potential side effects.
  
  
  
  The results from our study suggest that women's interactions and communication with their physician may be an important factor that contributes to the continued use of AET. Physicians who can communicate information about AET treatment benefits, purpose, and expectations in a way that patients can understand is a critical aspect of care that needs to be further studied.
authors.affiliation: Department of Health Services, University of Washington, Seattle, WA, USA. albert.j.farias@uth.tmc.edu.|School of Public Health, Department of Epidemiology and Human Genetics, University of Texas Health Sciences Center Houston, 1200 Pressler St., Suite E633, Houston, TX, 77035, USA. albert.j.farias@uth.tmc.edu.
authors.forename: Albert J
authors.initials: AJ
authors.lastname: Farias
authors.affiliation: Department of Health Services, University of Washington, Seattle, WA, USA.
authors.forename: India J
authors.initials: IJ
authors.lastname: Ornelas
authors.affiliation: Fred Hutchinson Cancer Research Center, Public Health Sciences Division, Seattle, WA, USA.
authors.forename: Sarah D
authors.initials: SD
authors.lastname: Hohl
authors.affiliation: Department of Health Services, University of Washington, Seattle, WA, USA.|Department of Veterans Affairs Puget Sound Health Care System, Health Services Research and Development Center of Excellence, Seattle, WA, USA.
authors.forename: Steven B
authors.initials: SB
authors.lastname: Zeliadt
authors.affiliation: Department of Pharmacy, University of Washington, Seattle, WA, USA.
authors.forename: Ryan N
authors.initials: RN
authors.lastname: Hansen
authors.affiliation: Fred Hutchinson Cancer Research Center, Public Health Sciences Division, Seattle, WA, USA.|University of Washington, Department of Epidemiology, Seattle, WA, USA.
authors.forename: Christopher I
authors.initials: CI
authors.lastname: Li
authors.affiliation: Department of Health Services, University of Washington, Seattle, WA, USA.|Fred Hutchinson Cancer Research Center, Public Health Sciences Division, Seattle, WA, USA.
authors.forename: Beti
authors.initials: B
authors.lastname: Thompson
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000523:psychology*; D017024:Chemotherapy, Adjuvant / Q000941:ethics* / Q000523:psychology; D003142:Communication; D003657:Decision Making; D005260:Female; D006801:Humans; D008875:Middle Aged; D010817:Physician-Patient Relations / Q000941:ethics*
keywords: Adjuvant endocrine therapy; Breast cancer; Physician-patient communication; Qualitative study; Survivors