Impact of motivational interviewing on psychosocial and symptom outcomes during breast cancer endocrine therapy

Abstract

PURPOSE: Adjuvant endocrine therapy (ET) is recommended to women with hormone receptor-positive (HR +) breast cancer for 5-10 years to reduce recurrence risk and mortality, but adhering to ET for this full period is challenging due to the physical and psychosocial effects of treatment. We sought to understand how participation in a patient-centered counseling intervention affected anxiety and depression, 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. Survey data collected at baseline and 12 months assessed anxiety and depression, and cancer recurrence worry. 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. Most participants were over 50 (63%), non-Black and non-Hispanic (63%; 97%). Overall patient-reported anxiety and depression decreased from baseline to 12 months, though only the change in anxiety was statistically significant, while cancer worry increased slightly. The most reported endocrine symptoms were hot flashes, night sweats, vaginal dryness, disinterest in sex, and joint pain; endocrine symptoms did not vary by age.

CONCLUSION: This study shows early promise in the efficacy of MI to improve anxiety, depression, recurrence worry, and treatment-related endocrine symptoms.