Factors associated with longer endocrine therapy use by South Carolina Medicaid-insured breast cancer survivors

Abstract

Purpose The objective of this study is to determine demographic, clinical, and pharmaceutical factors that are associated with longer endocrine therapy usage duration. Methods South Carolina Central Cancer Registry incidence data linked with South Carolina Medicaid prescription claims and administrative data were used. The study included a sample ( N = 1399) of female South Carolina Medicaid recipients with hormone receptor-positive breast cancer diagnosed between 2000 and 2012 who filled at least one ET prescription. A series of multiple regression models were built to explore the association of demographic, clinical, and pharmaceutical factors with the endocrine therapy usage duration. Results Multiple linear regression analysis showed that none of the demographic or clinical factors tested were significantly associated with the endocrine therapy usage duration. However, the type of endocrine therapy taken as well as receipt of the prescriptions that could have been used to alleviate side-effects (adrenals, nonsteroidal anti-inflammatory agents, anti-inflammatory agents, and vitamins) were significantly associated. Conclusion Our study highlights the potential value of concurrent prescriptions for improving the endocrine therapy usage duration, with an optimal intervention point before 14 months post ET initiation. This work informs further research needed to test pharmacologic interventions that may significantly increase the endocrine therapy duration as well as other nonpharmacologic strategies for side-effect management.

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

“…Seven studies [ 19 , 30 , 40 , 42 , 54 , 55 , 74 ] measured persistence subjectively, by simply asking participants if they were still taking their HT medication. Eleven studies used indirect measures of persistence, including medical records [ 36 , 46 , 63 , 82 ] and pharmacy databases [ 29 , 37 , 45 , 50 , 51 , 59 , 62 ].…”

“…The most frequently used validated measures were the Breast Cancer Prevention Trial (BCPT) symptom checklist [ 21 , 38 , 54 , 56 , 74 , 77 , 92 ], Centre for Epidemiologic Studies–Depression (CES-D) [ 37 , 43 , 54 , 56 , 64 ], Hospital Anxiety and Depression Scale (HADS) [ 15 , 32 , 34 , 56 , 66 , 74 , 88 ] and the Brief Pain Inventory (BPI) [ [32] , [33] , [34] , 36 , 57 , 81 ]. Three studies used the proxy measure of pharmacy records of prescriptions for the management of HT side effects [ 29 , 51 , 75 ]. Two studies used medical records of dropout due to HT adverse effects [ 48 , 65 ], 1 study used medical records of diagnosed issues linked to side effects [ 59 ], and 2 used medical records of side effects [ 61 , 63 ].…”

Preoperative Serum Hypersensitive-c-Reactive-Protein (Hs-CRP) to Albumin Ratio Predicts Survival in Patients with Luminal B Subtype Breast Cancer

“…Endocrine therapy is the main adjuvant treatment for hormone receptor positive breast cancer, and mainly includes: 13 , 14 1) selective estrogen receptor modulator (SERM), such as tamoxifen and toremifene; 2) aromatase inhibitors (AIs), such as letrozole, anastrozole, and exemestane; and 3) estrogen receptor antagonist, such as fulvestrant. All enrolled patients received endocrine therapy after operation.…”