Patient-reported factors associated with adherence to adjuvant endocrine therapy after breast cancer: an integrative review

Lambert, Leah; Balneaves, Lynda G.; Howard, A. Fuchsia; Gotay, Carolyn

doi:10.1007/s10549-017-4561-5

Cited by 95 publications

(148 citation statements)

References 71 publications

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“…Despite the known efficacy of ET, up to 30% of patients with invasive HR+ breast cancer who are prescribed ET never initiate therapy [9]. In addition, 18% to 73% of patients who initiate ET do not complete the prescribed course of treatment [2,4,6,[9][10][11][12][13][14][15][16][17][18][19]. Early discontinuation of therapy is associated with increased recurrence and breast cancer-specific mortality rates, as well as higher medical costs [2,9,11,[18][19][20][21].…”

Section: Introductionmentioning

confidence: 99%

How patients experience endocrine therapy for breast cancer: an online survey of side effects, adherence, and medical team support

et al. 2020

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Purpose Many patients with hormone receptor-positive (HR+) breast cancer do not adhere to endocrine therapy (ET), and treatment-related side effects are often discussed by participants in online breast cancer forums. Our aim was to survey this unique group of patients about their ET-related experiences. Methods We partnered with patients active in breast cancer social media communities to develop a survey assessing ET-related side effects and medical team communication. Patients with a history of HR+ breast cancer who had received a recommendation to take ET were eligible to participate in the anonymous, online survey. Results Respondents included 2353 women and 54 men. Aromatase inhibitors were the most commonly used medication. Side effects were reported by 91.2%, were more often experienced by women than men (p < 0.001), and were primarily related to medication type. Approximately one-third of respondents discontinued therapy early. While most felt supported by their medical team, 31.5% reported that their side effects were dismissed or minimized. Survey respondents most frequently reported that a healthy diet and exercise, yoga/acupuncture, and vitamins/supplements were helpful in managing ET-related side effects. Conclusions ET-related side effects are very common, and one-third discontinued treatment early. Lifestyle changes and complementary therapies can be important tools for side effect management. One-third of patients did not feel that their side effects were taken seriously. Implications for Cancer Survivors This is the largest survey of ET use by participants in online breast cancer communities. Further research is needed to identify strategies to improve treatment adherence and to better manage ET-related side effects.

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Section: Introductionmentioning

confidence: 99%

How patients experience endocrine therapy for breast cancer: an online survey of side effects, adherence, and medical team support

et al. 2020

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“…Previous qualitative studies [ 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 ] have furthered our understanding of the subjective experience of AET. An integrative review of the findings from these studies indicates that non-adherence to AET is multifaceted and influenced by several psychosocial factors, such as the experience of side effects, negative attitudes towards AET or medication in general, lack of a routine, and unsatisfactory relationships with healthcare professionals [ 30 ]. This review highlights how some of the factors influencing non-adherence to AET (e.g., side effects, patient-provider communication) are similar to those for non-adherence to medications prescribed for other chronic conditions [ 31 , 32 ].…”

Section: Introductionmentioning

confidence: 99%

Women’s Beliefs on Early Adherence to Adjuvant Endocrine Therapy for Breast Cancer: A Theory-Based Qualitative Study to Guide the Development of Community Pharmacist Interventions

et al. 2018

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Adjuvant endocrine therapy (AET) taken for a minimum of five years reduces the recurrence and mortality risks among women with hormone-sensitive breast cancer. However, adherence to AET is suboptimal. To guide the development of theory-based interventions to enhance AET adherence, we conducted a study to explore beliefs regarding early adherence to AET. This qualitative study was guided by the Theory of Planned Behavior (TPB). We conducted focus groups and individual interviews among women prescribed AET in the last two years (n = 43). The topic guide explored attitudinal (perceived advantages and disadvantages), normative (perception of approval or disapproval), and control beliefs (barriers and facilitating factors) towards adhering to AET. Thematic analysis was conducted. Most women had a positive attitude towards AET regardless of their medication-taking behavior. The principal perceived advantage was protection against a recurrence while the principal inconvenience was side effects. Almost everyone approved of the woman taking her medication. The women mentioned facilitating factors to encourage medication-taking behaviors and cope with side effects. For adherent women, having trouble establishing a routine was their main barrier to taking medication. For non-adherent women, it was side effects affecting their quality of life. These findings could inform the development of community pharmacy-based adherence interventions.

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“…Studies have shown that self-efficacy and social support have a positive effect on drug adherence [ [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] ]. Self-efficacy, the belief in one's ability or confidence to successfully perform a task or behavior (i.e., taking their medication as prescribed, when traveling, not feeling well or experiencing side effects) [ 32 ], has been shown to influence adherence to EHT, with lower levels of perceived self-efficacy associated with decreased rates of adherence, while higher levels of perceived self-efficacy are associated with higher adherence rates [ [23] , [24] , [25] , [26] ]. Social support from friends and family is also an important determinant of ongoing EHT adherence.…”

Section: Introductionmentioning

confidence: 99%

“…Social support from friends and family is also an important determinant of ongoing EHT adherence. Women who have higher levels of social support had greater adherence compared with women with lower levels of social support from family and friends [ 24 , [27] , [28] , [29] , [30] , [31] ].…”

Section: Introductionmentioning

confidence: 99%

Improving adherence to endocrine hormonal therapy among breast cancer patients: Study protocol for a randomized controlled trial

Chalela

Muñoz

Inupakutika

et al. 2018

Contemporary Clinical Trials Communications

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Adjuvant endocrine hormonal therapy (EHT) is highly effective and appropriate for nearly all breast cancer patients with hormone receptor-positive tumors, which represent 75% of all breast cancer diagnoses. Long-term use of EHT reduces recurrence rates and nearly halves the risk of death during the second decade after diagnosis. Despite the proven benefits, about 33% of women receiving EHT do not take their medication as prescribed. This causes an increase in the risk for recurrence and death.To promote adherence to EHT among breast cancer patients, this study will develop and pilot-test an intervention consisting of 1) a bilingual, culturally tailored, personalized, interactive smartphone application (app); and 2) support from a patient navigator. The control group will receive usual care. This 2-group randomized control trial will recruit 120 breast cancer patients receiving EHT at the Mays Cancer Center at UT Health San Antonio. The two-year study will have 3-time assessments (baseline, 3 and 6 months).This theory-based intervention will empower patients' self-monitoring and management. It will facilitate patient education, identification/reporting of side effects, delivery of self-care advice, and simplify communication between the patient and the oncology team. The ultimate goal of this innovative multi-communication intervention is to improve overall survival and life expectancy, enhance quality of life, reduce recurrence, and decrease healthcare cost. The anticipated outcome is a scalable, evidence-based, and easily disseminated intervention with potentially broad use to patients using EHT and other oral anticancer agents.

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Patient-reported factors associated with adherence to adjuvant endocrine therapy after breast cancer: an integrative review

Cited by 95 publications

References 71 publications

How patients experience endocrine therapy for breast cancer: an online survey of side effects, adherence, and medical team support

How patients experience endocrine therapy for breast cancer: an online survey of side effects, adherence, and medical team support

Women’s Beliefs on Early Adherence to Adjuvant Endocrine Therapy for Breast Cancer: A Theory-Based Qualitative Study to Guide the Development of Community Pharmacist Interventions

Improving adherence to endocrine hormonal therapy among breast cancer patients: Study protocol for a randomized controlled trial

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