A systematic review of interventions to improve adherence to endocrine therapy

Abstract

that few behavioral intervention studies were conducted on improving adherence to ET therapy. Therefore, the purposes of this systematic review were to explore studies that examined the impact of interventions or strategies to improve ET adherence among women with BrCa, and identify studies offering insights for future researchers designing interventions to improve ET adherence. Given the known health disparities of BrCa survivors that may contribute to lack of ET adherence, 18,27,28 we additionally sought to examine whether any studies discussed adaptations or considerations aimed to target the unique needs of disparate populations. Methods Inclusion and Exclusion Criteria. Studies included in this review met the following criteria: original research in peer-reviewed journals, full-text available online, clearly stated descriptions of samples and methodology, human subjects, adults, and articles available in English. We focused on papers that examined strategies and approaches for improving adherence to ET among women with BrCa. We defined ET as tamoxifen and/or aromatase inhibitors, the two major classes of drugs used for hormone positive BrCa. We included studies with a broad range of designs to capture data that examined a direct relationship between adherence and any strategy that could be replicated in an intervention. For example, if a study reported modifiable factors e.g., self-efficacy, patient-provider communication)in association with adherence as an outcome, we included the study. We excluded any descriptive manuscripts which did not document strategies to improve adherence. Search Strategy.

Improving Adherence to Adjuvant Hormonal Therapy Among Disadvantaged Women Diagnosed with Breast Cancer in South Carolina: Proposal for a Multimethod Study

“…Findings from this research will help fill a gap in our current understanding of underlying modifiable factors that influence adherence to AHT, particularly among understudied disparate populations [ 4 ]. To our knowledge, no previous study has applied a multi-level intervention approach to improve adherence to AHT [ 39 ]. Applying this approach to the cancer treatment and survivorship phases of the cancer control continuum is novel because most multi-level research in this area focuses on prevention and screening [ 26 , 40 ].…”

“…There is a similar pattern within the field of breast cancer research, where there are fewer intervention studies that focus on improving breast cancer treatment outcomes, compared to screening [ 41 , 42 ]. Among the studies that focus on improving adherence to AHT, few have found significant intervention effects [ 39 , 43 - 45 ] or are currently analyzing data [ 46 ].…”

Perceptions of Endocrine Therapy in African-American Breast Cancer Survivors: Mixed Methods Study

“…We conducted a literature review on interventions that improve endocrine therapy adherence, which identified 2 consequential gaps in existing intervention research: use of education only interventions and a lack of cultural adaptations [9][10][11][12][13][14][15][16]. Next, we examined commercially available cancer and medication adherence mobile health (mHealth) apps as a possible option to address these gaps and assist African-American women with endocrine therapy adherence [17][18][19][20][21].…”

“…The purpose of this concurrent convergent mixed methods study [28] was to provide further data to guide the development of the proposed culturally sensitive mHealth app, STORY+ for African-American women with breast cancer. Our initial work has been reported [14,[29][30][31][32][33][34]. The aims of this study were to (1) assess the use of smartphones and computers related to health care in African-American women with breast cancer, and (2) identify foundational aspects to support endocrine therapy adherence for incorporation in an mHealth app.…”

Oral Antineoplastics: Treatment Adherence and Medication Beliefs

“…Adherence to OA is an important indicator of therapeutic response 2,3,6,8,9 . Several studies have shown that poor adherence may affect treatment efficacy, toxicity, public health expenditures, patient survival time, and increase mortality risk [1][2][3][5][6][7][8][9][10][11][12] . For women with hormone receptor-positive breast cancer, for example, mortality can reach up to 49% of nonadherents 8 .…”