Do patients with HER2+ MBC and their HCPs speak the same language? Perceptions and uses of chronic disease and metastatic treatment arising from the EtnobreastHER2 study.

Abstract

Qualitative evidence on how patients with human epidermal growth factor receptor 2 metastatic breast cancer (HER2 + MBC) and healthcare professionals (HCPs) understand the concepts of "chronicity" and "palliative" terms is scarce. This study explored the meanings and perceptions of chronic disease and metastatic treatments. qualitative, observational, multicenter and cross-sectional study with HER2 + MBC patients. Qualitative data collected through remote semi-structured interviews with patients (n = 14) and HCPs (n = 10). Themes were identified using a phenomenological approach. Regarding the views and preferences of the term chronic in relation to HER2 + MBC, four different perspectives emerged: 1) the realistic, 2) the optimistic, 3) the critical, and 4) the episodic. For HCPs, there were two differing points of view: 1) advocates for the presentation of HER2 + MBC as chronic, and 2) against presenting the disease as chronic. Regarding the views and impacts of metastatic treatments, it was found that there was miscommunication on the use of the term palliative, leading patients to understand their condition at end of life, and not curative as all oncologists and half of the nurses intended. Results emphasize the need for a shared understanding of the meaning of chronic disease and palliative treatment for effective patient-doctor communication. To optimize communication, it is essential to understand patients' perspective of chronic diseases, preferences in terminology uses, and the impact throughout patients' journeys. "chronicity" and "palliative" in treatment options explanation and medical follow-up should be used more effectively by HCPs. This will be achieved if patients' needs are placed at the center, to adapt to different patient profiles and expectations.