A recent pilot study investigated the use of an intervention to educate patients on self-management of side effects related to antiestrogen use for reducing breast cancer risk or recurrence. The pilot project was conducted by Kaitlyn Fishman, MSN, DNP, AGPCNP-BC, of MetroWest Cancer Center in Cambridge, Massachusetts, and colleagues, and the group’s findings were reported in the Clinical Journal of Oncology Nursing.

“Although the project did not establish statistical significance between the educational intervention and medication adherence or side effect severity, it established clinical significance in making patients feel supported as well as identifying and reversing therapy discontinuation,” Dr Fishman and colleagues wrote in their report.

In this project involving high-risk patients being treated at a community oncology clinic, the researchers had goals of assessing medication adherence and side effect severity. They also aimed to provide nurse-led patient education regarding self-management of antiestrogen side effects for these patients.

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Eligible patients were adults who had been assigned female gender at birth and who had begun receiving antiestrogen therapy during the prior 6 months. Patients were interviewed about symptom severity and treatment adherence via telephone at baseline, which was during the first 6 months after treatment initiation, and during a follow-up 6 weeks later. Standard education and recommendations for self-management of side effects were provided in these calls, and educational brochures were mailed to patients.

A total of 12 patients participated in the study, median age 60.5 years, with 2 patients lost to follow-up. Prior to the intervention, patient reports on treatment adherence indicated that 3 of the 12 participants had missed a treatment dose during the previous week. Following the intervention, 1 in 10 participants reported missing a dose in the previous week.

Participants’ activity levels before and after the intervention also were reported, based on the Godin-Shephard Leisure-Time Physical Activity Questionnaire. Prior to the intervention, 4 of the 12 participants initially reported being active, and 5 of 10 reported being active after the intervention.

There were not significant differences reported before and after the intervention across various measurements of pain. The researchers reported that clinical significance in management of side-effect burden was demonstrated, however. A patient who had discontinued treatment, because of side effects, reinitiated treatment after the intervention. Her feedback indicated she felt greater support with the intervention.

“Integrating nurse-led telehealth education into practice is a feasible and accessible intervention that may help promote adherence to antiestrogen medications and improve communication between patients and their care teams,” the researchers concluded in their report.


Fishman K, Rosenthal B, Oupravanh M, Davenport Alonso EL. A nursing educational intervention to improve antiestrogen adherence and self-management of side effects. Clin J Oncol Nurs. 2022;26(6):606-611. doi:10.1188/22.CJON.606-611