Optimizing expectations about endocrine treatment for breast cancer: Results of the randomized controlled psy-breast trial
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Optimizing expectations about endocrine treatment for breast cancer: Results of the randomized controlled psy-breast trial. / Shedden-Mora, Meike C.; Pan, Yiqi; Heisig, Sarah R.; von Blanckenburg, Pia; Rief, Winfried; Witzel, Isabell; Albert, Ute Susann; Nestoriuc, Yvonne.
in: Clinical Psychology in Europe, Jahrgang 2, Nr. 1, e2695, 03.2020.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Optimizing expectations about endocrine treatment for breast cancer: Results of the randomized controlled psy-breast trial
AU - Shedden-Mora, Meike C.
AU - Pan, Yiqi
AU - Heisig, Sarah R.
AU - von Blanckenburg, Pia
AU - Rief, Winfried
AU - Witzel, Isabell
AU - Albert, Ute Susann
AU - Nestoriuc, Yvonne
N1 - Publisher Copyright: © 2020 PsychOpen. All rights reserved.
PY - 2020/3
Y1 - 2020/3
N2 - Background: Medication side effects are strongly determined by non-pharmacological, nocebo mechanisms, particularly patients' expectations. Optimizing expectations could minimize side effect burden. This study evaluated whether brief psychological expectation management training (EXPECT) optimizes medication-related expectations in women starting adjuvant endocrine therapy (AET) for breast cancer. Method: In a multisite randomized controlled design, 197 women were randomized to EXPECT, supportive therapy (SUPPORT), or treatment as usual (TAU). The three-session cognitivebehavioral EXPECT employs psychoeducation, guided imagery, and side effect management training. Outcomes were necessity-concern beliefs about AET, expected side effects, expected coping ability, treatment control expectations, and adherence intention. Results: Both interventions were well accepted and feasible. Patients' necessity-concern beliefs were optimized in EXPECT compared to both TAU and SUPPORT, d = .41, p < .001; d = .40, p < .001. Expected coping ability and treatment control expectations were optimized compared to TAU, d = .35, p = .02; d = .42, p < 001, but not to SUPPORT. Adherence intention was optimized compared to SUPPORT, d = .29, p = .02, but not to TAU. Expected side effects did not change significantly. Conclusion: Expectation management effectively and partly specifically (compared to SUPPORT) modified medication-related expectations in women starting AET. Given the influence of expectations on long-term treatment outcome, psychological interventions like EXPECT might provide potential pathways to reduce side effect burden and improve quality of life during medication intake.
AB - Background: Medication side effects are strongly determined by non-pharmacological, nocebo mechanisms, particularly patients' expectations. Optimizing expectations could minimize side effect burden. This study evaluated whether brief psychological expectation management training (EXPECT) optimizes medication-related expectations in women starting adjuvant endocrine therapy (AET) for breast cancer. Method: In a multisite randomized controlled design, 197 women were randomized to EXPECT, supportive therapy (SUPPORT), or treatment as usual (TAU). The three-session cognitivebehavioral EXPECT employs psychoeducation, guided imagery, and side effect management training. Outcomes were necessity-concern beliefs about AET, expected side effects, expected coping ability, treatment control expectations, and adherence intention. Results: Both interventions were well accepted and feasible. Patients' necessity-concern beliefs were optimized in EXPECT compared to both TAU and SUPPORT, d = .41, p < .001; d = .40, p < .001. Expected coping ability and treatment control expectations were optimized compared to TAU, d = .35, p = .02; d = .42, p < 001, but not to SUPPORT. Adherence intention was optimized compared to SUPPORT, d = .29, p = .02, but not to TAU. Expected side effects did not change significantly. Conclusion: Expectation management effectively and partly specifically (compared to SUPPORT) modified medication-related expectations in women starting AET. Given the influence of expectations on long-term treatment outcome, psychological interventions like EXPECT might provide potential pathways to reduce side effect burden and improve quality of life during medication intake.
KW - Adjuvant endocrine treatment
KW - Breast cancer
KW - Expectation management
KW - Nocebo effect
KW - Oncology
KW - Psychological intervention
KW - Side effect
U2 - 10.32872/cpe.v2i1.2695
DO - 10.32872/cpe.v2i1.2695
M3 - SCORING: Journal article
AN - SCOPUS:85097831894
VL - 2
JO - Clinical Psychology in Europe
JF - Clinical Psychology in Europe
SN - 2625-3410
IS - 1
M1 - e2695
ER -