Adherence status to Adjuvant Endocrine Therapy in Chinese Women with Early Breast Cancer and its influencing factors: A cross‐sectional survey

Abstract

Objective: Despite the proven benefits of adjuvant endocrine therapy, adherence to oral endocrine therapy in breast cancer treatment is a substantial problem. The aim of this study was to assess adherence to adjuvant endocrine therapy by women in China for the first 5 years, and to identify its influencing factors. Methods: Stratified sampling method was adopted to select 1875 cases of breast cancer patients for cross-sectional telephone follow-up. Compliance to medications was assessed using the Morisky Medication Adherence Scale. Status of endocrine therapy was assessed using nine additional questions. Binomial regression was used when assessing the factors associated with persistence, multinomial regression models were used to assess factors associated with compliance. Results: Of 888 patients who started adjuvant endocrine therapy, 769(86.6%) persisted and 119 (13.4%) discontinued. 760 patients who completed Morisky Medication Adherence Scale, the compliance was 7.4% low, 42% medium, and 50.6% high. The type of medication, duration of medication and side effects had an impact both on persistence and compliance. Age, history of radiotherapy and caregivers only had an impact on persistence. Conclusions: Medication adherence was affected by many factors. Special attention and interventions should be given to women taking tamoxifen in the 2nd to 3rd year of medication, and aromatase inhibitors in the 1st to 2nd year. Further prospective design studies are needed to explore effective measures to improve medication adherence of women with breast cancer treated by endocrine therapy. K E Y W O R D Sadherence, breast cancer, compliance, endocrine therapy, oncology, persistence

Development of a Prognostic App (iCanPredict) to Predict Survival for Chinese Women With Breast Cancer: Retrospective Study

“…The insufficient and unbalanced medical resources, information disparity between physicians and women with breast cancer, distrust of breast-conserving surgery by some physicians and women, and fear of recurrence are important reasons for the low rate of breast-conserving surgery in China [14]. In addition, for women with breast cancer in China who had received adjuvant endocrine therapy, the nonpersistence rates ranged from 5.9% to 22.6% in years 1-5, and the rate of low compliance ranged from 2.1% to 11.2% [19]. The low compliance with endocrine therapy may be partially explained by inadequate information and social support [19][20][21][22][23].…”

“…In addition, for women with breast cancer in China who had received adjuvant endocrine therapy, the nonpersistence rates ranged from 5.9% to 22.6% in years 1-5, and the rate of low compliance ranged from 2.1% to 11.2% [19]. The low compliance with endocrine therapy may be partially explained by inadequate information and social support [19][20][21][22][23]. Therefore, demonstrating the similar survival rate of different surgeries and the efficacy of adherence to endocrine therapy may help physicians and women with breast cancer make better clinical decisions.…”

The impact of medication side effects on adherence and persistence to hormone therapy in breast cancer survivors: A quantitative systematic review

“…Most studies used self-report adherence measures. The most frequently used validated self-report measures were the Medication Adherence Rating Scale (MARS) [ 84 ], [ 4 , 31 , 49 , 78 ], the 8-item Morisky Medication Adherence Scale (MMAS-8) [ 85 ], [ 35 , 52 , 57 ], and the 4-item Morisky Medication Adherence Scale (MMAS-4) [ 86 ] [ 64 , 72 , 73 , 80 ]. Seven studies created their own adherence measure [ 38 , 53 , 58 , 67 , 69 , 70 , 87 ].…”

The relationship among psychosocial adaptation, medication adherence and quality of life in breast cancer women with adjuvant endocrine therapy

“…This may be related to the increasing rate of medication discontinuation over time, or to the younger age of the study subjects and the common practice of clinical endocrine therapy for 5 years. Studies have shown that women taking a single drug for breast cancer are more likely to stop taking their medication over a period of two to three years [ 25 , 26 ].…”