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Barriers to and facilitative processes of endocrine therapy adherence among women with breast cancer

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Abstract

The treatment of chronic illness, and the prevention of disease progression and recurrence, often involve long-term adherence to prescription medications in breast cancer. Despite the survival benefit of endocrine therapies, nonadherence remains high. In this study, we examined barriers to and facilitators of endocrine therapy adherence among women with breast cancer (n = 1371). Participants currently taking tamoxifen or aromatase inhibitors were recruited from Dr. Susan Love Research Foundation’s Army of Women® Registry. Participants responded online to open-ended and close-ended questions about thoughts, feelings, and behaviors relevant to endocrine therapy. Two weeks later, women were invited to complete a second online questionnaire regarding current endocrine therapy adherence. Approximately one-third (36 %) of participants reported the presence of factors that make endocrine therapy difficult; reporting any barrier to medication adherence was significantly associated with nonadherence (P < 0.001). In addition, 31 % of women used one or more strategies to maintain their motivation to adhere and the use of cognitive self-talk (e.g., thoughts regarding endocrine therapy efficacy) was related to higher adherence. Hierarchical linear regressions revealed a significant behavioral barrier × behavioral facilitator interaction (P < 0.05); participants who endorsed a behavioral barrier in the absence of a behavioral facilitator reported the lowest adherence. Findings suggest that a sizeable minority of women face barriers to taking endocrine therapy, which are associated with nonadherence.

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Fig. 1

Adapted Morisky Adherence Scale

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Acknowledgments

This research was supported by funding from the Breast Cancer Research Foundation (Stanton).

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Authors and Affiliations

  1. Department of Psychology, University of California, 1285 Franz Hall, Box 90095-1563, Los Angeles, CA, USA

    Emma E. Bright & Annette L. Stanton

  2. Department of Psychological Medicine, University of Auckland, Auckland, New Zealand

    Keith J. Petrie

  3. Dana-Farber Cancer Institute, Brigham and Women’s Hospital, Harvard Medical School, Boston, USA

    Ann H. Partridge

  4. Departments of Psychology and Psychiatry/Biobehavioral Sciences, Center for Cancer Prevention and Control Research, Jonsson Comprehensive Cancer Center, University of California, Los Angeles, CA, USA

    Annette L. Stanton

Authors
  1. Emma E. Bright
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  2. Keith J. Petrie
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  3. Ann H. Partridge
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  4. Annette L. Stanton
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Correspondence to Emma E. Bright or Annette L. Stanton.

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Bright, E.E., Petrie, K.J., Partridge, A.H. et al. Barriers to and facilitative processes of endocrine therapy adherence among women with breast cancer. Breast Cancer Res Treat 158, 243–251 (2016). https://doi.org/10.1007/s10549-016-3871-3

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  • DOI: https://doi.org/10.1007/s10549-016-3871-3

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