Adherence to Adjuvant Aromatase Inhibitor Therapy Among Postmenopausal Hispanic/Latino Women With Breast Cancer

Abstract

The mean age was 61.6±9.4 years, and 109 (91.6%) selfidentified as Hispanic/Latino. A total of 58% reported an annual income of $15,000 or less. Overall, 40.3% had completed eighth grade or less education, 31.9% high school, and 12% had obtained a technical degree. The majority of patients (56%) had either a medium (45%) or a low level of adherence (11%). High adherence was noted in 44% of participants. Seven (5.6%) patients scored 2 or below on a 4-point scale for intentional adherence, and 18 (13.5%) scored 2 or below on a 4-point scale for unintentional adherence. Conclusion: These data suggest that the majority of Hispanic/Latino women with breast cancer have medium or low levels of adherence to therapy with AIs. Factors associated with medium and low adherence were unintentional (forgetfulness), but also included intentional factors, such as avoidance of adverse effects and delays with obtaining refills (cost-related nonadherence). Breast cancer (BC) is the second leading cause of cancer death after lung cancer in the United States (1). In 2018, the American Cancer Association estimated that there were 252,700 new cases of BC in the United States and 41,000 deaths from the disease (1). It is the major type of cancer among Hispanic/Latino women in the United States, with approximately 20,000 new cases and 3,000 deaths per year(2). From 2003 to 2018, the incidence rate of BC remained stable in both Hispanic and non-Hispanic White women (2). The use of screening mammography and advances in treatment modalities including the use of adjuvant endocrine therapy have contributed to the reduction of mortality from BC in the United States by approximately 24% since 1990 (3). Multiple studies have shown substantial benefits from adjuvant endocrine therapy in improving progression-free and overall survival (4-7). For almost two decades, adjuvant endocrine therapy with an aromatase inhibitor (AI) has remained a gold-standard for patients with hormonal receptor-positive BC. In 2003, the first results of ATAC (arimidex, tamoxifen, alone or in combination) phase 857 This article is freely accessible online.

Effect of a Smart Pill Bottle Reminder Intervention on Medication Adherence, Self-efficacy, and Depression in Breast Cancer Survivors

“…Considering that antihormonal aromatase must be taken daily and that forgetfulness is one of the barriers to medication adherence among breast cancer survivors, 18–20 interventions involving daily reminders would be more beneficial than those based on weekly reminders. In this study, the duration of reminder intervention was 28 days.…”

Adherence and Beliefs to Adjuvant Hormonal Therapy in Patients with Breast Cancer: A Cross-Sectional Study (Conference Paper) #

“…There is no standard method to measure medication adherence precisely (25) . Non-adherence is a multifactorial problem that affects therapy outcomes and lead to disease recurrence, re-hospitalization, and decrease survival rate (26) . Several studies found that socioeconomic status and clinical data including older age, single, low income and out-of-pocket cost of AHT (26)(27)(28)(29)(30)(31) , comorbidity, treatment side effects, depression (32)(33)(34) are associated with non-adherence.…”

Leveraging Electronic Health Records to Address Breast Cancer Disparities

“…These portals can also support patient communication with providers about managing their symptoms [38]. This strategy reduced anxiety and improved treatment adherence among patients undergoing active treatment with endocrine therapy or oral chemotherapy [2,3]. This adherence is important because hormone therapy reduces deaths due to breast cancer; yet, almost 50% of patients do not complete standard 5-year courses of treatment [39,40].…”

“…In fact, Black women are 40% more likely than White women to die of breast cancer due to genetic predisposition, aggressive tumor biology, differential access to health care, and social determinants of health [2]. Compared with White women, racial and ethnic minority groups, as well as rural and underserved populations, have less access to specialty care for breast cancer and a disproportionate risk of breast cancer-specific mortality associated with poverty, obesity, and lower treatment adherence [2][3][4].…”