Evaluation of a telehealth service to support breast cancer prevention medication uptake: a protocol of a mixed methods study

Introduction Breast cancer risk can be substantially reduced with risk-reducing medications (RRMeds). Despite their efficacy, and guidelines which support their use for women at substantially increased risk of breast cancer, they are underused. Barriers to their use in Australia include a lack of aw...

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Main Authors: Tim Spelman, Stephanie Best, Christobel Saunders, Paul A James, Sarah Latham, Louise A Keogh, Sarah Mason, Katrina Louise West, Wanda Cui, Sabine Deij, Sandy Minck, Catherine Poliness, Greg Wheeler, Kelly Anne Phillips
Format: Article
Language:English
Published: BMJ Publishing Group 2025-06-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/15/6/e098198.full
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author Tim Spelman
Stephanie Best
Christobel Saunders
Paul A James
Sarah Latham
Louise A Keogh
Sarah Mason
Katrina Louise West
Wanda Cui
Sabine Deij
Sandy Minck
Catherine Poliness
Greg Wheeler
Kelly Anne Phillips
author_facet Tim Spelman
Stephanie Best
Christobel Saunders
Paul A James
Sarah Latham
Louise A Keogh
Sarah Mason
Katrina Louise West
Wanda Cui
Sabine Deij
Sandy Minck
Catherine Poliness
Greg Wheeler
Kelly Anne Phillips
author_sort Tim Spelman
collection DOAJ
description Introduction Breast cancer risk can be substantially reduced with risk-reducing medications (RRMeds). Despite their efficacy, and guidelines which support their use for women at substantially increased risk of breast cancer, they are underused. Barriers to their use in Australia include a lack of awareness of RRMeds by women and clinicians, and a primary care workforce that reports a lack of knowledge and confidence in discussing and/or prescribing these medications. In contrast, Australian clinicians have reported specialist support and guidance as a key facilitator. The Preventing Cancer with Medications (PCMed) Telehealth Service was therefore developed to provide this specialist support and to bridge the evidence–implementation gap. The PCMed Service endeavours to increase the appropriate use of RRMeds and support women and their doctors throughout treatment. The aim of this research is to evaluate the effectiveness, adoption, acceptability, feasibility, fidelity and cost of this new Service, and to determine any adaptations that might be required.Methods and analysis The research uses a mixed methods approach. Effectiveness of the PCMed Service will be evaluated by determining whether the PCMed Service is associated with increased uptake of RRMeds compared with historical data. Secondary outcomes include: adoption of the Service, specifically, the proportion of women who attend a PCMed Service consultation; acceptability of the Service for clients and referring clinicians (using a brief survey and semistructured interviews); feasibility and fidelity by evaluating the adherence to the planned Service processes; and the cost, by reporting the difference between funding received per woman and the cost for service delivery.Ethics and dissemination This study was approved by the institutional Human Research Ethics Committee (EC00235): HREC/101142/PMCC. The findings will inform future iterations of the Service prior to scaling up. Research findings will be disseminated at scientific meetings and in peer-reviewed journals.Trial registration number ISRCTN15718519.
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spelling doaj-art-1a4a85a3c58a4e6caaa130cc5f58dfda2025-08-20T02:07:55ZengBMJ Publishing GroupBMJ Open2044-60552025-06-0115610.1136/bmjopen-2024-098198Evaluation of a telehealth service to support breast cancer prevention medication uptake: a protocol of a mixed methods studyTim Spelman0Stephanie Best1Christobel Saunders2Paul A James3Sarah Latham4Louise A Keogh5Sarah Mason6Katrina Louise West7Wanda Cui8Sabine Deij9Sandy Minck10Catherine Poliness11Greg Wheeler12Kelly Anne Phillips13Burnet Institute, Melbourne, Victoria, AustraliaCentre for Health Services Research and Implementation Science, Peter MacCallum Cancer Centre, Melbourne, Victoria, AustraliaDepartment of Surgery, The University of Melbourne Melbourne Medical School, Melbourne, Victoria, AustraliaThe Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Victoria, AustraliaDepartment of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, AustraliaCentre for Health Equity, The University of Melbourne School of Population and Global Health, Melbourne, Victoria, AustraliaThe Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Victoria, AustraliaDepartment of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, AustraliaDepartment of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, AustraliaThe Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Victoria, AustraliaDivision of Research, Peter MacCallum Cancer Centre, Melbourne, Victoria, AustraliaThe Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Victoria, AustraliaThe Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Victoria, AustraliaDepartment of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, AustraliaIntroduction Breast cancer risk can be substantially reduced with risk-reducing medications (RRMeds). Despite their efficacy, and guidelines which support their use for women at substantially increased risk of breast cancer, they are underused. Barriers to their use in Australia include a lack of awareness of RRMeds by women and clinicians, and a primary care workforce that reports a lack of knowledge and confidence in discussing and/or prescribing these medications. In contrast, Australian clinicians have reported specialist support and guidance as a key facilitator. The Preventing Cancer with Medications (PCMed) Telehealth Service was therefore developed to provide this specialist support and to bridge the evidence–implementation gap. The PCMed Service endeavours to increase the appropriate use of RRMeds and support women and their doctors throughout treatment. The aim of this research is to evaluate the effectiveness, adoption, acceptability, feasibility, fidelity and cost of this new Service, and to determine any adaptations that might be required.Methods and analysis The research uses a mixed methods approach. Effectiveness of the PCMed Service will be evaluated by determining whether the PCMed Service is associated with increased uptake of RRMeds compared with historical data. Secondary outcomes include: adoption of the Service, specifically, the proportion of women who attend a PCMed Service consultation; acceptability of the Service for clients and referring clinicians (using a brief survey and semistructured interviews); feasibility and fidelity by evaluating the adherence to the planned Service processes; and the cost, by reporting the difference between funding received per woman and the cost for service delivery.Ethics and dissemination This study was approved by the institutional Human Research Ethics Committee (EC00235): HREC/101142/PMCC. The findings will inform future iterations of the Service prior to scaling up. Research findings will be disseminated at scientific meetings and in peer-reviewed journals.Trial registration number ISRCTN15718519.https://bmjopen.bmj.com/content/15/6/e098198.full
spellingShingle Tim Spelman
Stephanie Best
Christobel Saunders
Paul A James
Sarah Latham
Louise A Keogh
Sarah Mason
Katrina Louise West
Wanda Cui
Sabine Deij
Sandy Minck
Catherine Poliness
Greg Wheeler
Kelly Anne Phillips
Evaluation of a telehealth service to support breast cancer prevention medication uptake: a protocol of a mixed methods study
BMJ Open
title Evaluation of a telehealth service to support breast cancer prevention medication uptake: a protocol of a mixed methods study
title_full Evaluation of a telehealth service to support breast cancer prevention medication uptake: a protocol of a mixed methods study
title_fullStr Evaluation of a telehealth service to support breast cancer prevention medication uptake: a protocol of a mixed methods study
title_full_unstemmed Evaluation of a telehealth service to support breast cancer prevention medication uptake: a protocol of a mixed methods study
title_short Evaluation of a telehealth service to support breast cancer prevention medication uptake: a protocol of a mixed methods study
title_sort evaluation of a telehealth service to support breast cancer prevention medication uptake a protocol of a mixed methods study
url https://bmjopen.bmj.com/content/15/6/e098198.full
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