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      Efficacy of a web-based women’s health survivorship care plan for young breast cancer survivors: a randomized controlled trial

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          Abstract

          PURPOSE:

          Breast cancer survivorship care plans (SCP) have limited content addressing women’s health issues. This trial tested if young breast cancer survivors who receive a web-based, women’s health SCP were more likely to improve on at least one of four targeted issues (hot flashes, fertility-related concerns, contraception and vaginal symptoms) compared to attention controls.

          METHODS:

          A randomized controlled trial recruited female survivors ages 18–45 at diagnosis, 18–50 at enrollment, completed primary cancer treatment, and had a significant women’s health issue: moderate fertility-related concerns; ≥4 hot flashes/day with ≥1 of moderate severity; ≥1 moderate vaginal atrophy symptom; or not contracepting/using less effective methods. Survivors underwent stratified, block randomization with equal allocation to intervention and control groups. The intervention group accessed the online SCP; controls accessed curated resource lists. In intention-to-treat analysis, the primary outcome of improvement in at least one issue by 24 weeks was compared by group.

          RESULTS:

          182 participants (86 intervention, 96 control), mean age 40.0±5.9 and 4.4±3.2 years since diagnosis, were randomized. Sixty-one intervention group participants (70.9%) improved, compared to 55 controls (57.3%) (OR 1.82, 95%CI0.99–3.4, p=0.057). The following issue-specific improvements were observed in the intervention versus control arms: fertility-related concerns (27.9% vs. 14.6%, OR 2.3, 95%CI 1.1–4.8); hot flashes (58.5% vs. 55.8%, OR 1.1, 95%CI 0.57–2.2); vaginal symptoms (42.5% vs. 40.7%, OR 1.1, 95%CI 0.6–2.0); contraception (50% vs. 42.6%, OR 1.4, 95%CI 0.74–2.5).

          CONCLUSIONS:

          In young breast cancer survivors, a novel, web-based SCP did not result in more change in the primary outcome of improvement in at least one of the 4 targeted women’s health issues, over the attention control condition. The intervention was associated with improved infertility concerns, supporting efficacy of disseminating accessible, evidence-based women’s health information to this population.

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          Author and article information

          Journal
          8111104
          1254
          Breast Cancer Res Treat
          Breast Cancer Res. Treat.
          Breast cancer research and treatment
          0167-6806
          1573-7217
          4 May 2019
          03 May 2019
          August 2019
          01 August 2020
          : 176
          : 3
          : 579-589
          Affiliations
          [1 ]Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Diego
          [2 ]Moores Cancer Center, University of California, San Diego
          [3 ]Department of Family and Preventive Medicine, University of California, San Diego
          [4 ]Department of Medicine, University of California, San Diego
          [5 ]Young Survival Coalition
          [6 ]Department of Chemical and Biomolecular Engineering, University of Notre Dame
          [7 ]School of Social and Behavioral Health Sciences, Oregon State University College of Public Health and Human Sciences
          [8 ]Southern California Center for Sexual Health and Survivorship Medicine
          [9 ]Bendheim Integrative Medicine Center, Memorial Sloan Kettering Cancer Center
          Author notes
          Corresponding author: H. Irene Su, MD MSCE, Moores Cancer Center, University of California, San Diego, 3855 Health Sciences Drive, Dept. 0901, La Jolla, CA 92093-0901, hisu@ 123456ucsd.edu , Tel: 858-822-5986, Fax: 858-822-2399
          Article
          PMC6626763 PMC6626763 6626763 nihpa1528597
          10.1007/s10549-019-05260-6
          6626763
          31054032
          4a67b8bb-affa-4cf5-ab74-40fcce00e745
          History
          Categories
          Article

          randomized controlled trial,breast cancer,survivorship care plan,reproductive health,fertility

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