Antiemetics

Gastrointestinal Agents

All Drugs and Chemicals

Routine care consists of an oncology pharmacist counselling the patient on supportive care medications prior to the patient getting his or her prescription dispensed.

The intervention group will encompass the oncology pharmacist using the computer system to print a Picture Medication Calendar for the patient and use the calendar to explain supportive medications, in addition to routine care.

Picture Medication Calendar

Venita Harris, PharmD

Determine if an oncology pictorial medication calendar will improve patient adherence to oncology supportive care medication regimens for adult patients receiving adjuvant or neo-adjuvant chemotherapy treatment for cancer.

Primary Objective: In order to evaluate the impact of such an approach on adherence, a prospective, open-label, randomized controlled pilot trial (RCT) was carried out to determine if a picture-based medication calendar would improve patient adherence to antiemetic medication regimens for adult patients receiving chemotherapy treatment for solid organ tumor origins.

The secondary objectives were: 1) to assess medication use and self-efficacy parameters, 2) to determine patient comfort with antiemetic regimen prescribed along with chemotherapy and 3) to determine patient satisfaction with the calendar study tool.

A Trial to Assess the Influence of a Pictorial Medication Calendar on Medication Taking Behaviour

A Randomized Controlled Trial to Assess the Influence of a Picture-Based Antiemetic Medication Calendar on Medication-Taking Behavior in Adults Receiving Chemotherapy

Adherence is quantified as the number of doses taken of a prescribed agent divided by the number of doses prescribed, expressed as a percentage. Pill counts were utilized to calculate the number of missed doses or pills taken as a percentage of the total number prescribed and dispensed.

The participant survey conducted at end of study was investigator-created and asked questions regarding demographics and medication taking behaviors. Questions specifically related to the calendar for those in the intervention arm were also asked. Questions regarding satisfaction with the calendar as well as complexity of medication regimen for oncologic treatment were assessed using a 5-point Likert scale.

19 The tool measures an individual's perceived ability to understand information about prescribed medicines, and to follow instructions for use.

University of Waterloo

Medbuy Corporation

London Health Sciences Centre

Lawson Health Research Institute

Neoplasms

Urinary Tract, Sexual Organs, and Pregnancy Conditions

All Conditions

Uterine Cervical Neoplasms

Women with HPV self-collected tests will receive a multicomponent intervention which includes SMS text messages to remind them to attend triage. In addition, CHWs will receive reminders via e-mails to contact women if after 60 days from the HPV-results HPV+ they have not performed triage.

Women with HPV self-collected tests receive usual care. Upon opting for the HPV self-collected test, women will be instructed to go to the health care center in 30 days to pick up the results.

Women with HPV self-collected tests will receive a multicomponent intervention which includes SMS text messages to remind them to attend triage. In addition, CHWs will receive reminders via e-mails to contact women if after 60 days from the HPV-results HPV+ they have not performed triage

Multicomponent mHealth Intervention

Silvina Arrossi, Phd

Background: Cervical cancer is one of the leading causes of cancer death among women worldwide, with more than 85% of cases occurring in low- and middle-income countries. Human papillomavirus (HPV) screening allows for self-collection with the potential to increase coverage, but still requires triage to identify which HPV+ women need diagnostic and treatment procedures. However, achieving high levels of triage adherence can be challenging, especially among socially vulnerable women. The ATICA protocol (Application of Communication and Information Technologies to Self-Collection, for its initials in Spanish), aimed at evaluating the implementation strategy and the effectiveness of a multi-component mobile health (mHealth) intervention to increase adherence to triage among women with HPV+ self-collected tests. Methods: Researchers will use an effectiveness-implementation hybrid type I trial with a mixed-methods evaluation approach. A cluster randomized trial design including 200 community health workers (CHWs) will evaluate whether the mHealth intervention increases adherence to triage among HPV+ women who self-collected at home during a CHW visit within 120 days after a positive result. The intervention includes an initial mobile phone text message (SMS) alert and subsequent reminders sent to HPV+ women. For those who do not adhere to triage within 60 days of a positive HPV test, an email and SMS will be sent to the CHWs to promote contact with these women during home visits. Reserchers will use the Consolidated Framework for Implementation Research (CFIR) as an organizing and analytic framework to evaluate the implementation of the intervention while also drawing on Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM). Researchers will conduct a self-administered, semi-structured survey of CHWs, semi-structured interviews with local health authorities, and a survey of HPV+ women.

Cervical cancer is a disease of health and gender inequalities, and is primarily a cancer of poor, socially vulnerable women. Even though it is almost entirely preventable, in Latin America it is the leading cause of cancer death among women.1 In Argentina, it is the second cause of female cancer death: every year 5,000 women are diagnosed with cervical cancer and more than 1,800 die from the disease.1 In this country, and generally across Latin America, high mortality is related to problems in the continuity of the prevention process, including low screening coverage and loss to follow-up, diagnosis, and treatment.2,3 New screening tests detect the presence of high-risk types of HPV which cause cervical cancer. HPV tests have important advantages over the Pap as a primary screening test, including higher sensitivity (over 90%)4 and a high negative predictive value,5 which allow reduced screening frequencies. Very importantly, through self-collection strategies, HPV testing can reduce barriers to screening and increase coverage.6 HPV self-collection is highly accurate,7 and is acceptable among women in different countries.8-11 However, HPV screening identifies women who are HPV+ (around 10%). Triage tests for HPV+ women determine those who need additional diagnostic procedures. While several triage methods are available for detecting precancerous lesions, including cytology and colposcopy,12 to date most such triage methods require HPV+ women to attend health centers to determine appropriate follow-up. Although adherence to follow-up and treatment is a widespread problem for cervical cancer programs in Latin America,2 evidence for interventions to improve adherence to follow-up is lacking.

The introduction of self-administered HPV testing in Jujuy has been successful in increasing primary cervical cancer screening coverage. Yet the proportion of self-collected HPV+ cases who currently undertake cytological triage within 120 days of screening is low (about 30%), which hinders the impact of the increased HPV screening coverage attained.

Aims of the study

1. To evaluate the effectiveness of a mHealth intervention targeted to women and health providers to increase adherence to cytological triage among self-tested HPV+ women compared to usual practice.
2. To identify and understand the processes and factors which contribute to the success of the mHealth intervention strategy (or lack thereof).

Setting Jujuy province is located in northwest Argentina and 85% of its population live in urban areas.19 The primary health care (PHC) system has 270 health centres and employs about 700 full-time CHWs who visit approximately 110,000 households twice a year for health-related tasks.

Since 2012, HPV-testing has been the primary CC screening test, available for women aged 30 years or older attending public health centres. Women are screened with HPV-testing every five years. Since 2014, HPV self-collection is offered during the CHW routine home visits. Women self-collect samples with a cervical sampler kit (Qiagen, Gaithersburg, MD, USA), which is comprised of a cervical brush, specimen container, and transport medium. Community health workers transport specimens at room temperature to health centres; from where they are sent to the provincial HPV laboratory to be analysed for 13 high-risk HPV types using hybrid-capture 2, following the manufacturer's instructions. According to the national guidelines,21 HPV-positive women with self-collected tests must go through cytology (triage Pap), and those HPV-positive women whose triage Paps are classified as atypical squamous cells of undetermined significance or worse (ASCUS+) are referred to colposcopy, then to biopsy if colposcopy images are classified as abnormal following the International Federation of Cervical Pathology and Colposcopy (IFCPC) classification.22 Women with histologically confirmed cervical intraepithelial neoplasia (CIN) of grade 2 or worse are referred to treatment.

All HPV-testing/diagnoses/treatments of women screened in the public health system are registered on the national screening information system (SITAM, for its initials in Spanish). Results of HPV tests and triage Paps are instantly available online to providers at public health establishments.

Setting The research will take place in the province of Jujuy, located in Northwest Argentina. Eighty-five percent of Jujuy's population lives in urban areas and the rate of mobile phone penetration was 82% of urban households in 201113 Jujuy has a high cervical cancer mortality rate (10.6 per 100.000 women during 2012-2014).

The Jujuy public health system includes a main hospital and 300 primary health care centers. For the uninsured, health services are provided free of cost. The Primary Health Care System (PHC) integrates approximately 700 paid full-time community health workers (CHWs) who twice yearly visit approximately 110,000 households for health-related tasks such as immunization and promoting maternal and child health.

Study design The study design follows the structure of an effectiveness-implementation hybrid type I trial14 and uses a mix-methods approach.

It combines a cluster randomized trial to evaluate the effectiveness of a multi-component mHealth intervention with a mixed methods approach involving quantitative and qualitative evaluations of the implementation using the RE-AIM15 and Consolidated Framework for Implementation Research (CFIR)16 frameworks.

The study will integrate quantitative and qualitative methods and follow Greene's typology of mixed-methods for convergence and complementarity.17 A formative research will be carried out to develop the framing and content of SMS messages (qualitative secondary method).

Then a pragmatic cluster randomized trial will be carried out to measure the effectiveness of the multi-component mHealth intervention in improving triage adherence among HPV+ women (quantitative primary method for Specific Aim 1).

Finally, during the post-intervention phase (Implementation evaluation for Specific Aim 2), a quantitative survey will be carried out to measure acceptability of the strategy by CHWs (quantitative secondary method), and semi-structured interviews (qualitative secondary methods) will be conducted among health authorities and health professionals,18 to receive feedback on their own perspectives and opinions about the intervention.19 HPV+ women will also be interviewed via a structured questionnaire (quantitative secondary method) to collect information about acceptability of the intervention, reasons for triage adherence/non-adherence, and their views about the strategy.

Formative research. Focus group discussions (FGD) will be carried out to explore women's opinions about how to frame and phrase SMS messages. Barriers women face in accessing triage will be explored, and the resulting information will be used to develop strategies CHWs can use to address them during the intervention. Drawing from FGD results, SMS messages will be designed and pilot tested with a validation protocol that has already been used in Argentina.20 Development of Automated Messaging system: an Automated System (AS) will be developed, which will then send SMS messages and e-mails based on data from the national Screening Information System (SITAM). This AS will will work in an asynchronous manner. In order to avoid sending a SMS message to the wrong person, an identity verification process will be initiated. Only matching data will be classified as "valid" and receive subsequent SMS messages. E-mails sent to CHWs will not include personal information about women, but a secure link to registries of women to be viewed in SITAM. SMS messages and e-mails will comply with security procedures.

Intervention: cluster-randomized trial. Approximately 200 CHWs from Jujuy's PHC will be randomized into two groups: 1) mHealth Intervention (MH) Group: Women with positive self-collected tests will receive a multi-component intervention. HPV+ women will receive periodic SMS messages during the first month after registration of self-collection test result in SITAM, notifying them that test results are available and they should go to the health center. In addition, CHWs will receive an e-mail and SMS message prompting them to visit those HPV+ women who, at 60 days since availability of the HPV result in SITAM, have not attended triage. CHWs will be asked to confirm receipt of the e-mail for monitoring project processes. Within 15 days of being notified, CHWs will visit these HPV+ women, for an in-person reminder and counseling about the importance of attending health centers and have triage performed. 2) Usual Care (UC) Group: Women with positive self-collected tests will receive usual care, i.e., women opting for self-collection will be instructed to go the health center in 30 days to pick up results.

Hypothesis: Adherence to triage will be higher in the MH intervention group compared to women receiving UC.

Study procedures. CHWs from both groups will identify eligible women and invite them to participate in the study during their routine home visits. Once women have performed HPV-self collection, CHWs will screen for eligibility criteria, including use of mobile phones. Those women who use a mobile phone will be explained the study objectives and will be invited to participate in the study. Women accepting to participate will be asked to provide a telephone number. Based on previous studies,21,22 the investigators expect approximately 85% of women will provide a telephone number; with 70% providing their own personal mobile phone.

MH Group: CHWs will carefully explain participants the sequence of SMS messages to be received depending on the Test results, and how they should proceed after reception of the SMS messages. If the woman does not have a personal phone, she will be asked if she is willing to be contacted and receive the proposed SMS messages on a shared phone. CHWs will inform women about the nature and content of the SMS messages to be received. They will also explain that if they have not performed triage 60 days after a positive test results they will come back for an in-person visit. Therefore, consent to participate also means women agreement to be contacted and to receiving SMS messages, even if phones are shared by several family members.

Upon SITAM registration of the HPV result, a first SMS message will be sent requiring women a confirmatory reply with their id number. This confirmatory approach to assure a patient's identity has been used and proved effective in other studies.22,23 After confirmation, women will receive a second SMS message with different information depending on their HPV status: if HPV-, they will be informed about the result and date of next screening; if HPV+, they will be informed that test results are available at the health center. Women will know in advance that this SMS message will mean they are HPV+. During the first four weeks after registration of a HPV result in SITAM, a SMS message will be sent weekly unless a Pap result is registered in SITAM. Sixty days after the date of registration of the HPV test result in SITAM, CHWs will receive an e-mail and SMS message informing them that there are HPV+ women who have not had Pap triage (if this is the case). The e-mail will contain a secure link to the list of HPV+ women to be visited. CHWs will be asked to confirm receipt of the e-mail for monitoring project processes. CHWs will visit these HPV+ women within 15 days of being notified, for an in-person reminder and counseling about the importance of attending health centers and have triage performed. CHW visit information will be recorded, including visit attempts, date of visit and issues addressed during counseling.

UC care group: Once women have agreed to participate in the project, CHWs will provide UC counseling using specific24 standard provincial protocol and materials. They will inform women that they should go to the health center in a month to get their test results.

Randomization and sample size: All CHWs (clusters) (approximately 700) of the Jujuy province offer self-collection and will be eligible to participate in the study. After classifying them into four groups according to gender and urban/rural setting, a stratified sample of 240 CHWs will be randomly selected with allocation proportional to strata. Selected CHWs will be invited to participate in the study following the order defined by the random list until 200 are enrolled. Enrolled CHWs will be randomly allocated to the MH or the UC group (3:2 ratio). Blinding of intervention and outcome assessments is not feasible due to the characteristics of the study. Primary outcome: The target sample size (120 CHWs in the MH group and 80 CHWs in the UC group, each one providing 2 HPV+ women) will have 97% power to detect a 20% triage difference between the two groups when the control group has a 30% triage in a 120-days period (two-sided test, alpha=0.05). Correlation induced by the CHWs was included in power calculations assuming an intra-class correlation coefficient of 0.10. Secondary outcome: Under the same assumptions, the proposed sample size will have 90% power to detect a difference of 10% in triage between groups when the control group has a 15% triage by day 60.

Analysis plan: All analysis will be conducted in an intention-to-treat basis, i.e. an enrolled woman with a positive HPV result will be considered in the study group assigned to her CHW, regardless of adherence of the CHW to the intervention or the number of SMS messages delivered to the woman. The effect of the multi-component mHealth intervention on the primary outcome will be assessed using a generalized estimating equations approach. The model, logit link, and binomial distribution will include trial group as fixed effect and CHWs as the clustering variable. Potential modification of the effect of the intervention due to rural/urban location of the woman and CHW gender will be evaluated, additionally including these factors and their interactions with study group in the former model. Baseline women factors will be compared between groups. Factors showing clear unbalance between arms will be included in the model proposed above to adjust for potential confounding. The same approach will be used to estimate the intervention effect on the secondary outcome. An interrupted time series approach will be used to explore the differential impact of each component of the intervention (SMS messages to women from day 1-59, SMS message and e-mail to CHWs by day 60) on the total number of women with triage at each week. Baseline for each woman will be defined as the day the HPV tests results are recorded in SITAM. Segmented regression will be used to assess the trend of the outcome in each period (1-59; 60-120 days) and any potential discontinuity (change in level or profile) in the time series of the intervention group compared to the control group. A linear model accounting for the autocorrelation of the data and including period (1-59; 60-120 days), intervention indicator (yes/no), and functions of time before and after the breakpoint (date when the second component starts) will be fitted. Given that the number of HPV+ women with triage is not expected to follow a linear trend with time, smooth functions (spline) of time will be used to model the relation between outcome and time in each study group. Under the assumption that the trend in the outcome would remain unchanged in the absence of the second component, this approach will allow investigators to describe the counterfactual curve expected in the intervention group had the second component not been implemented. Analyses will be conducted using STATA and/or SAS. The trial will follow the CONSORT extension for cluster randomized trials reporting guidelines 25.

Evaluation of a mHealth Intervention to Increase Adherence to Triage of Self-collected HPV+ Women (ATICA Project)

Mixed-Methods Approach to Evaluate a mHealth Intervention to Increase Adherence to Triage of HPV+ Women Who Have Performed Self-collection

The percentage of women with triage Pap smears at 120 days after HPV results are registered in the national screening information system (SITAM). This will allow measurement of the overall effect of the multi-component intervention including two periods: a) the 60 day period between the Test results and the SMS message and e-mail sent to Community Health Workers (CHW) (days 1-59); and b) the 60 day period between the SMS message and e-mail sent to CHWs and triage measurement (days 60-120)

The percentage of women with triage Pap smears at 60 days after HPV results are registered in SITAM (days 1-59). This outcome will allow us to measure the individual effect of the SMS messages sent to women (before CHWs receive prompts to contact non compliant HPV+ women).

Dana-Farber Cancer Institute

Deakin University

Centro de Estudio de Estado y Sociedad

None untoward or unfavorable medical occurrences were detected related to the participant's participation in the research.

Women with HPV self-collected tests will receive a multicomponent intervention which includes SMS text messages to remind them to attend triage. In addition, CHWs will receive reminders via e-mails to contact women if after 60 days from the HPV-results HPV+ they have not performed triage.

Multicomponent mHealth Intervention: Women with HPV self-collected tests will receive a multicomponent intervention which includes SMS text messages to remind them to attend triage. In addition, CHWs will receive reminders via e-mails to contact women if after 60 days from the HPV-results HPV+ they have not performed triage

Usual Care

Total

Age, Categorical

Sex: Female, Male

Race and Ethnicity were not collected from any participant.

Race and Ethnicity Not Collected

Argentina

Region of Enrollment

Triage Pap smear

Dr. Silvina Arrossi

Percentage of Women With Triage Pap Smears at 120 Days After HPV Results

Percentage of Women With Triage Pap Smears at 60 Days After HPV Results

Overall Study

Skin and Connective Tissue Diseases

Breast Neoplasms

Breast Diseases

Skin Diseases

Patients follow the classic support prescription of hormonotherapy

Patients follow the 4 sessions of PEP hormonotherapy. The therapeutic education prgram is led by a trained educational team, inside a prevention center : Hygée centre.

therapeutic education program

Aurélie Bourmaud, MD

The purpose of this study is to evaluate the feasibility and the effectiveness of a patient education program on patients' adherence to adjuvant hormone therapy (anti-estrogen or aromatase inhibitors) for breast cancer, in collaboration with teams of sociologists, patient education and medical oncologists.

Therapeutic Education Intervention in Breast Cancer: PEPs Hormonotherapy

Development and Evaluation of a Therapeutic Education Intervention Focused on the Accession of Patients Treated With Hormonal Therapy in the Management of Breast Cancer: PEPs Hormonotherapy

compliance measure with prescription refillment and questionnaire. At the inclusion and at the end of the study

measure of the patients' competence with a specific questionnaire of scenarii

Measuring the level of knowledge of patients with a specific quizz

Measuring the level of patient anxiety with HAD scale

Measuring the level of confidence with a visual analogic scale

quality of life evaluated with the EQ-5D questionnaire

Institut de Cancérologie de la Loire

Behaviors and Mental Disorders

Quality of Life

The intervention arm are the women who received the ACTS Intervention. It is a 45 minute intervention provided by a breast cancer survivor. The intervention includes a discussion of the patient's attitudes towards chemotherapy, communication strategies with providers, the recommended treatment in accordance with tumor size and tumor characteristics

ACTS (Attitudes, Communication, Treatment, Support) Intervention is a onetime intensive 45 minute intervention delivered by a black breast cancer survivor and utilizing video, graphics, teaching tools, and supportive testimony to encourage chemotherapy adherence.

ACTS Intervention

Usual Care will consist of standard therapy education by a registered nurse in the treatment center. Education and support from clinicians are offered as needed throughout the course of cancer treatment at all participating medical oncology clinics.

Margaret Q Rosenzweig, PhD,FNP-C

The ACTS (Attitudes, Communication, Treatment, Support) Intervention is a onetime, intensive psycho-educational intervention using a race-matched breast cancer survivor interventionist to: address Attitudes, including perceptions and stressors, that may impact adherence to clinical visits and treatment; encourage and model patient Communication with health care providers regarding physical and emotional needs, with attention to race-discordant situations; and provide tailored, understandable information about Treatment and its rationale. The Support component is threaded throughout the intervention via the presence of a race-matched breast cancer survivor and supportive video messages from the black community.

The 5-year survival after a first diagnosis of breast cancer is 13% lower in black than in white American women, an alarming disparity that cannot be explained by stage of disease at presentation. Nonadherence to breast cancer treatment and treatment delays from diagnosis to initiation of treatment may be among the reasons for worse breast cancer outcomes in black women. This recognition is critical because it suggests that breast cancer survival disparity can be decreased through clinical interventions that increase adherence to chemotherapy. The ACTS (Attitudes, Communication, Treatment, Support) Intervention is a onetime, intensive psycho-educational intervention using a race-matched breast cancer survivor interventionist to: address Attitudes, including perceptions and stressors, that may impact adherence to clinical visits and treatment; encourage and model patient Communication with health care providers regarding physical and emotional needs, with attention to race-discordant situations; and provide tailored, understandable information about Treatment and its rationale. The Support component is threaded throughout the intervention via the presence of a race-matched breast cancer survivor and supportive video messages from the black community. This study is a randomized controlled trial that will test the efficacy of the ACTS Intervention vs. Usual Care on the primary outcomes of adherence to recommended breast cancer chemotherapy.

There was no masking. This intervention was open.

The Attitudes, Communication, Treatment and Support Intervention to Reduce Breast Cancer Treatment Disparity

The ACTS Intervention to Reduce Breast Cancer Treatment Disparity

Overall study results will be published. Individual participant data will not be made available due to privacy issues.

Midpoint chemotherapy adherence was measured by recording the chemotherapy dose received/chemotherapy dose prescribed at the treatment midpoint via medical record review for each participant in both the ACTS Intervention and Usual Care groups.

Endpoint chemotherapy adherence was measured by recording the chemotherapy dose received/chemotherapy dose prescribed at the treatment endpoint via medical record review for each participant in both the ACTS Intervention and Usual Care groups.

Social Support will be assessed with the Interpersonal Support Evaluation List (ISEL-12), the shortened general population form. The ISEL was designed to assess the perceived availability of four separate functions of social support as well as providing an overall support measure. The items which comprise the ISEL fall into four 10-item subscales listed as tangible, appraisal, self esteem and belonging. Scoring is based on a 5 point Likert scale test-retest data reveal correlations between .77-.86 Cronbach alpha = .86

Symptom Occurrence and Severity Measure: The McCorkle Symptom Distress Scale (SDS) was developed in 1977 based on interviews with patients about their symptom experiences. Scores range from 1 to 5 on a Likert-type scale with 5 indicating most severe.157 Total symptom distress can be obtained as the unweighted sum of 13 items. If an item is scored as 3 or above it is considered to indicate serious distress. A cumulative score of 25 or more indicates moderate distress and any score above 33 indicates severe distress necessitating immediate intervention.149 The SDS can be administered as paper questionnaire.

Twenty two symptoms are assessed. If present, the patient is then asked if they reported the symptom to their doctor or nurse and if they received recommendations made by the health care team. The psychometrics for this instrument are not established. This instrument measures a key component of the ACTS Intervention, the ability to communicate distress to health care professionals. Scoring is dichotomous (yes/no) for experiencing the symptom and yes/no spoke with physician or nurse about that symptom. Total score is number of symptoms reported over number of symptoms total.

The Functional Assessment of Cancer Therapy is a 27- item self-report Likert scale questionnaire comprising four subscales-physical well being, social well being, functional well-being, and emotional well-being The FACT is designed to measure health-related quality of life for individuals with cancer.147 Each item is rated from on a scale of zero to four with zero equal to "not at all" and four equal to "very much." This questionnaire requires 5-7 minutes to complete. It has been determined appropriate for use in clinical oncology settings and shown to have good validity and reliability.148 In initial psychometric evaluation, the mean score for the FACT- G was 82.05 (SD 15.86)

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
A Trial to Assess the Influence of a Pictorial Medication Calendar on Medication Taking Behaviour	NCT04701736	Cancer Chemotherapy Medication Adhe...	Picture Medicat...	18 Years -	Lawson Health Research Institute
A Trial to Assess the Influence of a Pictorial Medication Calendar on Medication Taking Behaviour	NCT04701736	Cancer Chemotherapy Medication Adhe...	Picture Medicat...	18 Years -	Lawson Health Research Institute
Evaluation of a mHealth Intervention to Increase Adherence to Triage of Self-collected HPV+ Women (ATICA Project)	NCT03478397	Patient Adheren...	Multicomponent ...	30 Years -	Centro de Estudio de Estado y Sociedad
Therapeutic Education Intervention in Breast Cancer: PEPs Hormonotherapy	NCT02300675	Breast Cancer	therapeutic edu...	18 Years -	Institut de Cancérologie de la Loire
The Attitudes, Communication, Treatment and Support Intervention to Reduce Breast Cancer Treatment Disparity	NCT01184066	Breast Cancer	ACTS Interventi... Usual Care	18 Years -	University of Pittsburgh
Therapeutic Education Intervention in Breast Cancer: PEPs Hormonotherapy	NCT02300675	Breast Cancer	therapeutic edu...	18 Years -	Institut de Cancérologie de la Loire

Spots Global Cancer Trial Database for patient adherence