Evidence mapPaperPMID 34410568Full record

Trial reportBreast cancer research and treatment2021

Brief relaxation training is associated with long-term endocrine therapy adherence among women with breast cancer: post hoc analysis of a randomized controlled trial.

Molly E Ream, Emily A Walsh, Jamie M Jacobs, Chloe Taub, Marc Lippman, Natasha Schaefer-Solle, Steven A Safren, Michael H Antoni

Open access · greenAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Breast cancer research and treatment, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 1 pooled it
1.0field-weighted citation impact, top 21% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 1 synthesis or guideline pooled it, 16 citations in OpenAlex.

  1. A Systematic Review and Meta-Analysis of Interventions to Promote Adjuvant Endocrine Therapy Adherence Among Breast Cancer Survivors.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2023
    Pooled it
  2. Trial
  3. Trial
  4. Interventions to improve adherence to oral endocrine therapy for prevention or treatment of breast cancer in Black women of low socioeconomic status.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025
    Article
  5. Article
  6. Interventions to improve oral endocrine therapy adherence in breast cancer patients.Journal of cancer survivorship : research and practice · 2025
    Review
  7. Article
  8. Article
  9. Article
  10. Article
  11. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 1 country.

Molly E ReamDepartment of Psychology, University of Miami, 5665 Ponce de Leon, Coral Gables, FL, 33146, USA. mxr1940@miami.edu.ORCID http://orcid.org/0000-0002-6400-9739
Emily A WalshDepartment of Psychology, University of Miami, 5665 Ponce de Leon, Coral Gables, FL, 33146, USA.
Jamie M JacobsDepartment of Psychiatry, Massachusetts General Hospital, Boston, USA.
Chloe TaubDepartment of Psychology, University of Miami, 5665 Ponce de Leon, Coral Gables, FL, 33146, USA.
Marc LippmanGeorgetown University, Washington, USA.
Natasha Schaefer-SolleDepartment of Medicine, University of Miami, Coral Gables, USA.
Steven A SafrenDepartment of Psychology, University of Miami, 5665 Ponce de Leon, Coral Gables, FL, 33146, USA.
Michael H AntoniDepartment of Psychology, University of Miami, 5665 Ponce de Leon, Coral Gables, FL, 33146, USA.
University of Miami · USGeorgetown University · USHarvard University · US

Funding

FACILITATING POSITIVE ADAPTATION TO BREAST CANCERR01CA064710 · UNIVERSITY OF MIAMI CORAL GABLES · 1994 to 2003
$1.9M
The University of Miami AIDS Research Center on Mental Health and HIV/AIDS - Center for HIV & Research in Mental Health (CHARM)Research Core & MHD-CEP30MH133399 · UNIVERSITY OF MIAMI CORAL GABLES · 2025 to 2025
$1.5M
NCI NIH HHS 2R01-CA-064710NCI NIH HHS F31 CA254148NCI NIH HHS F31CA254148-01NCI NIH HHS R01 CA064710NIDA NIH HHS K24 DA040489NIH HHS 9K24DA040489NIMH NIH HHS P30 MH133399
6 · The paper itself

Abstract

purposeDespite life-saving potential, many women struggle to adhere to adjuvant endocrine therapy (AET) for their breast cancer (BCa). Prior research has demonstrated that emotional distress is a barrier to AET adherence. We followed women from a trial to test the long-term effects of two 5-week post-surgical group-based stress management interventions, cognitive behavioral therapy (CBT), and relaxation training versus an attention-matched health education control, on AET adherence.

methodsWe conducted a long-term follow-up (median = 8 years) of women randomized to CBT, relaxation training, or health education after surgery for stage 0-3 BCa. We measured adherence with the Endocrine Therapy Medication Usage Questionnaire (ETMUQ). First, we established factors on the ETMUQ via confirmatory factor analysis. We then used Bayesian structural equation modeling to regress these factors on study arm, controlling for age and treatments received.

resultsOf those who completed long-term follow-up (n = 59, 44.7%), over half (n = 33; 55.9%) reported problems with adherence generally. Women receiving relaxation training (n = 15) had better adherence than those receiving health education (n = 24) on the Forgetfulness/Inconsistency [B(SE) = 0.25(0.14), p = 0.049] and Intentional Nonadherence [B(SE) = 0.31(0.14), p = 0.018] factors of the ETMUQ. Similar results were observed for those receiving relaxation training compared to CBT (n = 20): Forgetfulness/Inconsistency [B(SE) = - 0.47(0.25), p = 0.031]; Intentional Nonadherence [B(SE) = - 0.31(0.15), p = 0.027].

conclusionWomen receiving relaxation training were less likely to (1) forget to take their AET and (2) intentionally miss doses of AET in the long term compared to women receiving health education or CBT. This is evidence for the need of randomized trials that aim to improve adherence by incorporating theoretically based behavioral change techniques. TRIAL REGISTRATION AND DATES: Trial 2R01-CA-064710 was registered March 26, 2006.

Indexed as

Breast NeoplasmsCognitive Behavioral TherapyBayes TheoremCombined Modality TherapyFemaleHumansMedication AdherenceAdherenceBehavior changeBreast cancerEndocrine therapyPsycho-oncology

Identifiers

PMID34410568
PMCPMC9245682
OpenAlexW3194989807

What Socratic holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.