Differences in older versus younger womenÕs experience and knowledge of adjuvant endocrine therapy (AET) for early breast cancer (EBC)

 

*Yvonne Wengstrom1, Alberto Costa2,  Susanna Leto3,  Vasoulla Georgiou 4 1 European Oncology Nursing Society and Section for Nursing, Karolinska Institutet, Stockholm, Sweden, 2 European School of Oncology, Milan, Italy, 3 Novartis Oncology, Region Europe, Origgio, Italy, 4Adelphi International Research, Bollington, UK

 

AET is used in the treatment of women with hormone sensitive EBC to reduce the risk of recurrence. Little is known about womenÕs experience of and knowledge about AET. The GAEA (Gathering Information on Adjuvant Endocrine therApy) Initiative aims to delineate womenÕs knowledge and experience of AET and develop programmes targeted at meeting their needs. A survey was carried out to determine BC patientsÕ knowledge about and attitudes towards AET, ascertain their informational and support needs while taking AET and define how best to meet these needs. The survey, which consisted of qualitative and quantitative phases, was conducted in 9 countries (Austria, France, Germany, Hungary, Italy, Spain, Sweden, Switzerland, and UK) that represent different regions of Europe and different size countries. During the qualitative phase 32 patients currently taking AET for EBC were interviewed to identify the correct parameters to explore, and language to use, in the quantitative survey. A quantitative questionnaire was developed on the basis of the findings from these interviews. This questionnaire was translated and pilot tested in the survey languages and women from the survey counties with post-menopausal EBC and currently taking AET were invited to take part in the survey.  A total of 546 women completed a questionnaire. 71% of those surveyed were between 51-70 years of age - 13% were 71 or over. The majority of respondents were retired and only 44% had internet access.  On average respondents had been taking AET for 2.6 years. Only 33% of women over 71 years of age were made aware of treatment options whereas 55% of women 60 years or younger were made aware of AET options. 57% of women over 71 years old were not at all involved in the decision to start on AET (average of 41%). In stark contrast only 22% of women 50 years or younger were not at all involved in decision making. Those who were not involved in decision making were much less likely to be satisfied with their level of involvement. They were also less likely to have been given information about AET. Overall younger women, women with a higher level of education and those with internet access were more likely to have received information about AET. Respondents looked for information about BC from a wide range of sources, however, older women utilised much fewer sources of information than younger women. Women from 61 years onwards were much more likely to indicate that treatment with AET had no impact on their everyday life – younger women were much more likely to indicate that it had a slight to large negative impact. Women with EBC need comprehensive and accurate information about different AET options in order to make informed choices. This research has highlighted gaps in meeting EBC patientsÕ informational needs and revealed the limited extent that women are involved in treatment decision-making, especially older women. Efforts are required to meet the informational and decision-making needs of the older women with BC.