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

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Abstract

Background

Adjuvant endocrine therapy (AET) significantly reduces recurrence and mortality in women with breast cancer (BrCa). Despite the efficacy of AET in improving BrCa outcomes, up to 50% of women do not adhere to prescribed AET regimens. While numerous demographic and clinical predictors influence adherence and persistence, few studies have identified the patient-reported factors that influence AET adherence and persistence.

Purpose

The aim was to examine the patient-reported personal, social, and structural factors influencing BrCa survivors’ adherence and persistence with AET.

Methods

An integrative review was undertaken wherein PubMed, Medline, CINAHL, Embase, and PsycINFO databases were searched using keyword descriptors and database subject headings. Inclusion criteria included quantitative or qualitative peer-reviewed studies written in English that assessed AET adherence and/or persistence through objective measurement or self-report and included patient-reported factors found to influence adherence and/or persistence. The data extracted from eligible studies were entered into a matrix, and systematically compared and iteratively analyzed using relational autonomy as an organizing theoretical framework.

Results

A total of 43 manuscripts (9 qualitative and 34 quantitative) were reviewed. Several personal, social, and structural factors were identified that influenced AET adherence and persistence, including side effects, necessity beliefs, self-efficacy, the patient–healthcare provider relationship, social support, and continuity of follow-up care.

Conclusions

An increasing number of studies have focused on identifying the patient-reported factors that influence AET adherence and persistence. This review highlights important personal, social, and structural factors that act as facilitators and barriers in adhering to and persisting with long-term AET. Acknowledging and addressing these factors is key to providing women with the care needed to improve suboptimal adherence and persistence.

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Abbreviations

AET:

Adjuvant endocrine therapy

AI:

Aromatase inhibitor

BrCa:

Breast cancer

HCP:

Healthcare provider

QOL:

Quality of life

References

  1. International Agency for Research on Cancer (2012) GLOBOCAN 2012: estimated cancer incidence, mortality and prevalence worldwide in 2012. http://globocan.iarc.fr/Pages/fact_sheets_cancer.aspx

  2. Berry DA, Cronin KA, Plevritis SK et al (2005) Effect of screening and adjuvant therapy on mortality from breast cancer. N Engl J Med 353:1784–1792. https://doi.org/10.1097/01.ogx.0000201966.23445.91

    Article  CAS  PubMed  Google Scholar 

  3. Burstein HJ, Prestrud AA, Seidenfeld J et al (2010) American Society of Clinical Oncology clinical practice guideline: update on adjuvant endocrine therapy for women with hormone receptor-positive breast cancer. J Clin Oncol 28:3784–3796. https://doi.org/10.1200/JCO.2009.26.3756

    Article  PubMed  PubMed Central  Google Scholar 

  4. Hershman D, Shao T, Kushi L et al (2011) Early discontinuation and non-adherence to adjuvant hormonal therapy are associated with increased mortality in women with breast cancer. Breast Cancer Res Treat 126:529–537. https://doi.org/10.1007/s10549-010-1132-4

    Article  CAS  PubMed  Google Scholar 

  5. Burstein HJ, Temin S, Anderson H et al (2014) Adjuvant endocrine therapy for women with hormone receptor-positive breast cancer: American Society of Clinical Oncology clinical practice guideline focused update. J Clin Oncol 32:2255–2269. https://doi.org/10.1200/JCO.2013.54.2258

    Article  PubMed  PubMed Central  Google Scholar 

  6. Davies C, Pan H, Godwin J et al (2013) Long-term effects of continuing adjuvant tamoxifen to 10 years versus stopping at 5 years after diagnosis of oestrogen receptor-positive breast cancer: ATLAS, a randomised trial. Lancet 381:805–816. https://doi.org/10.1016/S0140-6736(12)61963-1

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Hershman DL, Kushi LH, Shao T et al (2010) Early discontinuation and nonadherence to adjuvant hormonal therapy in a cohort of 8,769 early-stage breast cancer patients. J Clin Oncol 28:4120–4128. https://doi.org/10.1200/JCO.2009.25.9655

    Article  PubMed  PubMed Central  Google Scholar 

  8. Owusu C, Buist DSM, Field TS et al (2008) Predictors of tamoxifen discontinuation among older women with estrogen receptor-positive breast cancer. J Clin Oncol 26:549–555. https://doi.org/10.1200/JCO.2006.10.1022

    Article  PubMed  Google Scholar 

  9. van Herk-Sukel MPP, van de Poll-Franse LV, Voogd AC et al (2010) Half of breast cancer patients discontinue tamoxifen and any endocrine treatment before the end of the recommended treatment period of 5 years: a population-based analysis. Breast Cancer Res Treat 122:843–851. https://doi.org/10.1007/s10549-009-0724-3

    Article  PubMed  Google Scholar 

  10. Murphy CC, Bartholomew LK, Carpentier MY et al (2012) Adherence to adjuvant hormonal therapy among breast cancer survivors in clinical practice: a systematic review. Breast Cancer Res Treat 134:459–478. https://doi.org/10.1007/s10549-012-2114-5

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Gotay C, Dunn J (2011) Adherence to long-term adjuvant hormonal therapy for breast cancer. Expert Rev Pharmacoecon Outcomes Res 11:709–715. https://doi.org/10.1586/erp.11.80

    Article  PubMed  Google Scholar 

  12. Chlebowski RT, Geller ML (2007) Adherence to endocrine therapy for breast cancer. Oncology 71:1–9. https://doi.org/10.1159/000100444

    Article  Google Scholar 

  13. Banning M (2012) Adherence to adjuvant therapy in post-menopausal breast cancer patients: a review. Eur J Cancer Care (Engl) 21:10–19. https://doi.org/10.1111/j.1365-2354.2011.01295.x

    Article  CAS  Google Scholar 

  14. Whittemore R, Knafl K (2005) The integrative review: updated methodology. J Adv Nurs 52:546–553. https://doi.org/10.1111/j.1365-2648.2005.03621.x

    Article  PubMed  Google Scholar 

  15. Early Breast Cancer Trialists’ Collaborative Group (1998) Tamoxifen for early breast cancer: an overview of the randomised trials. Lancet 351:1451–1467. https://doi.org/10.1016/S0140-6736(97)11423-4

    Article  Google Scholar 

  16. Van Liew JR, Christensen AJ, de Moor JS (2014) Psychosocial factors in adjuvant hormone therapy for breast cancer: an emerging context for adherence research. J Cancer Surviv 8:521–531. https://doi.org/10.1007/s11764-014-0374-2

    Article  PubMed  Google Scholar 

  17. Cahir C, Guinan E, Dombrowski SU et al (2015) Identifying the determinants of adjuvant hormonal therapy medication taking behaviour in women with stages I–III breast cancer: a systematic review and meta-analysis. Patient Educ Couns 98:1524–1539. https://doi.org/10.1016/j.pec.2015.05.013

    Article  Google Scholar 

  18. Wuensch P, Hahne A, Haidinger R et al (2015) Discontinuation and non-adherence to endocrine therapy in breast cancer patients: is lack of communication the decisive factor? J Cancer Res Clin Oncol 141:55–60. https://doi.org/10.1007/s00432-014-1779-z

    Article  CAS  PubMed  Google Scholar 

  19. World Health Organization (2003) Adherence to long-term therapies: evidence for action. WHO, Geneva

    Google Scholar 

  20. U.S. Department of Health and Human Services FDA Center for Drug Evaluation and Research, U.S. Department of Health and Human Services FDA Center for Biologics Evaluation and Research, U.S. Department of Health and Human Services FDA Center for Devices and Radiological Health (2006) Guidance for industry: patient-reported outcome measures: use in medical product development to support labeling claims: draft guidance. Health Qual Life Outcomes 4:79. https://doi.org/10.1186/1477-7525-4-79

    Article  Google Scholar 

  21. Howell D, Fitch M, Bakker D et al (2013) Core domains for a person-focused outcome measurement system in cancer (PROMS-cancer core) for routine care: a scoping review and Canadian delphi consensus. Value Health 16:76–87. https://doi.org/10.1016/j.jval.2012.10.017

    Article  PubMed  Google Scholar 

  22. Howell D, Molloy S, Wilkinson K et al (2015) Patient-reported outcomes in routine cancer clinical practice: a scoping review of use, impact on health outcomes, and implementation factors. Ann Oncol 26:1846–1858. https://doi.org/10.1093/annonc/mdv181

    Article  CAS  PubMed  Google Scholar 

  23. Whittemore R (2005) Combining evidence in nursing research: methods and implications. Nurs Res 54:56–62. https://doi.org/10.1097/00006199-200501000-00008

    Article  PubMed  Google Scholar 

  24. Burns N (1989) Standards for qualitative research. Nurs Sci Q 2:44–52. https://doi.org/10.1177/089431848900200112

    Article  CAS  PubMed  Google Scholar 

  25. Sherwin S (1998) A relational approach to autonomy in health care. In: Sherwin S (ed) Politics of women’s health. Exploring agency and autonomy. Temple University Press, Philadelphia, pp 19–47

    Google Scholar 

  26. Friese CR, Pini TM, Li Y et al (2013) Adjuvant endocrine therapy initiation and persistence in a diverse sample of patients with breast cancer. Breast Cancer Res Treat 138:931–939. https://doi.org/10.1007/s10549-013-2499-9

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  27. Bradley CJ, Dahman B, Jagsi R et al (2015) Prescription drug coverage: implications for hormonal therapy adherence in women diagnosed with breast cancer. Breast Cancer Res Treat 154:417–422. https://doi.org/10.1007/s10549-015-3630-x

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Fink AK, Gurwitz J, Rakowski W et al (2004) Patient beliefs and tamoxifen discontinuance in older women with estrogen receptor-positive breast cancer. J Clin Oncol 22:3309–3315. https://doi.org/10.1200/JCO.2004.11.064

    Article  PubMed  Google Scholar 

  29. Lash TL, Fox MP, Westrup JL et al (2006) Adherence to tamoxifen over the five-year course. Breast Cancer Res Treat 99:215–220. https://doi.org/10.1007/s10549-006-9193-0

    Article  PubMed  Google Scholar 

  30. Cluze C, Rey D, Huiart L et al (2012) Adjuvant endocrine therapy with tamoxifen in young women with breast cancer: determinants of interruptions vary over time. Ann Oncol 23:882–890. https://doi.org/10.1093/annonc/mdr330

    Article  CAS  PubMed  Google Scholar 

  31. Huiart L, Bouhnik A-D, Rey D et al (2012) Early discontinuation of tamoxifen intake in younger women with breast cancer: is it time to rethink the way it is prescribed? Eur J Cancer 48:1939–1946. https://doi.org/10.1016/j.ejca.2012.03.004

    Article  PubMed  Google Scholar 

  32. Wouters H, Stiggelbout AM, Bouvy ML et al (2014) Endocrine therapy for breast cancer: assessing an array of women’s treatment experiences and perceptions, their perceived self-efficacy and nonadherence. Clin Breast Cancer 14(460–467):e2. https://doi.org/10.1016/j.clbc.2014.04.005

    Google Scholar 

  33. Wouters H, Maatman GA, Van Dijk L et al (2013) Trade-off preferences regarding adjuvant endocrine therapy among women with estrogen receptor-positive breast cancer. Ann Oncol 24:2324–2329. https://doi.org/10.1093/annonc/mdt195

    Article  CAS  PubMed  Google Scholar 

  34. Stanton AL, Petrie KJ, Partridge AH (2014) Contributors to nonadherence and nonpersistence with endocrine therapy in breast cancer survivors recruited from an online research registry. Breast Cancer Res Treat 145:525–534. https://doi.org/10.1007/s10549-014-2961-3

    Article  PubMed  Google Scholar 

  35. Bright EE, Petrie KJ, Partridge AH, Stanton AL (2016) Barriers to and facilitative processes of endocrine therapy adherence among women with breast cancer. Breast Cancer Res Treat 158:243–251. https://doi.org/10.1007/s10549-016-3871-3

    Article  PubMed  Google Scholar 

  36. Chim K, Xie SX, Stricker CT et al (2013) Joint pain severity predicts premature discontinuation of aromatase inhibitors in breast cancer survivors. BMC Cancer 13:401. https://doi.org/10.1186/1471-2407-13-401

    Article  PubMed  PubMed Central  Google Scholar 

  37. Brier MJ, Chambless DL, Gross R et al (2017) Perceived barriers to treatment predict adherence to aromatase inhibitors among breast cancer survivors. Cancer 123:169–176. https://doi.org/10.1002/cncr.30318

    Article  CAS  PubMed  Google Scholar 

  38. Kadakia KC, Snyder CF, Kidwell KM et al (2016) Patient-reported outcomes and early discontinuation in aromatase inhibitor-treated postmenopausal women with early stage breast cancer. Oncologist 21:539–546. https://doi.org/10.1634/theoncologist.2015-0349

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  39. Kidwell KM, Harte SE, Hayes DF et al (2014) Patient-reported symptoms and discontinuation of adjuvant aromatase inhibitor therapy. Cancer 120:2403–2411. https://doi.org/10.1002/cncr.28756

    Article  PubMed  PubMed Central  Google Scholar 

  40. Henry NL, Azzouz F, Desta Z et al (2012) Predictors of aromatase inhibitor discontinuation as a result of treatment-emergent symptoms in early-stage breast cancer. J Clin Oncol 30:936–942. https://doi.org/10.1200/JCO.2011.38.0261

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  41. Liu Y, Malin JL, Diamant AL et al (2013) Adherence to adjuvant hormone therapy in low-income women with breast cancer: the role of provider–patient communication. Breast Cancer Res Treat 137:829–836. https://doi.org/10.1007/s10549-012-2387-8

    Article  CAS  PubMed  Google Scholar 

  42. Kahn KL, Schneider EC, Malin JL et al (2007) Patient centered experiences in breast cancer: predicting long-term adherence to tamoxifen use. Med Care 45:431–439

    Article  PubMed  Google Scholar 

  43. Quinn EM, Fleming C, O’Sullivan MJ (2016) Endocrine therapy adherence: a cross-sectional study of factors affecting adherence and discontinuation of therapy. Ir J Med Sci 185:383–392. https://doi.org/10.1007/s11845-015-1307-4

    Article  CAS  PubMed  Google Scholar 

  44. Kimmick G, Edmond SN, Bosworth HB et al (2015) Medication taking behaviors among breast cancer patients on adjuvant endocrine therapy. Breast 24:630–636. https://doi.org/10.1016/j.breast.2015.06.010

    Article  PubMed  PubMed Central  Google Scholar 

  45. Aiello Bowles EJ, Boudreau DM, Chubak J et al (2012) Patient-reported discontinuation of endocrine therapy and related adverse effects among women with early-stage breast cancer. J Oncol Pract 8:e149–e157. https://doi.org/10.1200/JOP.2012.000543

    Article  PubMed  PubMed Central  Google Scholar 

  46. Atkins L, Fallowfield L (2006) Intentional and non-intentional non-adherence to medication amongst breast cancer patients. Eur J Cancer Care (Engl) 42:2271–2276. https://doi.org/10.1016/j.ejca.2006.03.004

    Article  Google Scholar 

  47. Kyvernitakis I, Ziller V, Hars O et al (2014) Prevalence of menopausal symptoms and their influence on adherence in women with breast cancer. Climacteric 17:252–259. https://doi.org/10.3109/13697137.2013.819327

    Article  CAS  PubMed  Google Scholar 

  48. Bender CM, Gentry AL, Brufsky AM et al (2014) Influence of patient and treatment factors on adherence to adjuvant endocrine therapy in breast cancer. Oncol Nurs Forum 41:274–285. https://doi.org/10.1188/14.ONF.274-285

    Article  PubMed  PubMed Central  Google Scholar 

  49. Hadji P, Jackisch C, Bolten W et al (2014) COMPliance and Arthralgia in Clinical Therapy: the COMPACT trial, assessing the incidence of arthralgia, and compliance within the first year of adjuvant anastrozole therapy. Ann Oncol 25:372–377. https://doi.org/10.1093/annonc/mdt513

    Article  CAS  PubMed  Google Scholar 

  50. Demissie S, Silliman RA, Lash TL et al (2001) Adjuvant tamoxifen: predictors of use, side effects, and discontinuation in older women. J Clin Oncol 19:322–328. https://doi.org/10.1200/JCO.2001.19.2.322

    Article  CAS  PubMed  Google Scholar 

  51. Brett J, Fenlon D, Boulton M et al (2016) Factors associated with intentional and unintentional non-adherence to adjuvant endocrine therapy following breast cancer. Eur J Cancer Care (Engl). https://doi.org/10.1111/ecc.12601

    Google Scholar 

  52. Hershman DL, Kushi LH, Hillyer GC et al (2016) Psychosocial factors related to non-persistence with adjuvant endocrine therapy among women with breast cancer: the breast cancer quality of care study (BQUAL). Breast Cancer Res Treat 157:133–143. https://doi.org/10.1007/s10549-016-3788-x

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  53. Wickersham KE, Sereika SM, Bender CM (2013) Pretreatment predictors of short-term nonadherence to oral hormonal therapy for women with breast cancer. Nurs Res 62:243–251. https://doi.org/10.1097/NNR.0b013e318298fd70

    Article  PubMed  PubMed Central  Google Scholar 

  54. Huiart L, Bouhnik A-DD, Rey D et al (2013) Complementary or alternative medicine as possible determinant of decreased persistence to aromatase inhibitor therapy among older women with non-metastatic breast cancer. PLoS ONE 8:e81677. https://doi.org/10.1371/journal.pone.0081677

    Article  PubMed  PubMed Central  Google Scholar 

  55. Grunfeld EA, Hunter MS, Sikka P, Mittal S (2005) Adherence beliefs among breast cancer patients taking tamoxifen. Patient Educ Couns 59:97–102. https://doi.org/10.1016/j.pec.2004.10.005

    Article  PubMed  Google Scholar 

  56. Arriola KRJ, Mason TA, Bannon KA et al (2014) Modifiable risk factors for adherence to adjuvant endocrine therapy among breast cancer patients. Patient Educ Couns 95:98–103. https://doi.org/10.1016/j.pec.2013.12.019

    Article  Google Scholar 

  57. Heisig SR, Shedden-Mora MC, von Blanckenburg P et al (2015) Informing women with breast cancer about endocrine therapy: effects on knowledge and adherence. Psychooncology 24:130–137. https://doi.org/10.1002/pon.3611

    Article  PubMed  Google Scholar 

  58. Albert U-S, Zemlin C, Hadji P et al (2011) The impact of breast care nurses on patients’ satisfaction, understanding of the disease, and adherence to adjuvant endocrine therapy. Breast Care 6:221–226. https://doi.org/10.1159/000329006

    Article  PubMed  PubMed Central  Google Scholar 

  59. Cahir C, Dombrowski SU, Kelly CM et al (2015) Women’s experiences of hormonal therapy for breast cancer: exploring influences on medication-taking behaviour. Support Care Cancer 23:3115–3130. https://doi.org/10.1007/s00520-015-2685-x

    Article  PubMed  Google Scholar 

  60. Wells KJ, Pan TM, Vázquez-Otero C et al (2016) Barriers and facilitators to endocrine therapy adherence among underserved hormone-receptor-positive breast cancer survivors: a qualitative study. Support Care Cancer 24:4123–4130. https://doi.org/10.1007/s00520-016-3229-8

    Article  PubMed  PubMed Central  Google Scholar 

  61. Wickersham K, Happ MB, Bender CM (2012) “Keeping the boogie man away”: medication self-management among women receiving anastrozole therapy. Nurs Res Pract 2012:1–9. https://doi.org/10.1155/2012/462121

    Article  Google Scholar 

  62. Pellegrini I, Sarradon-Eck A, Soussan PB et al (2010) Women’s perceptions and experience of adjuvant tamoxifen therapy account for their adherence: breast cancer patients’ point of view. Psychooncology 19:472–479. https://doi.org/10.1002/pon.1593

    Article  PubMed  Google Scholar 

  63. Brauer ER (2016) “Winging it”: how older breast cancer survivors persist with aromatase inhibitor treatment. J Oncol Pract 12:e991–e1000. https://doi.org/10.1200/JOP.2016.011767

    Article  PubMed  PubMed Central  Google Scholar 

  64. Farias AJ, Ornelas IJ, Hohl SD et al (2017) Exploring the role of physician communication about adjuvant endocrine therapy among breast cancer patients on active treatment: a qualitative analysis. Support Care Cancer 25:75–83. https://doi.org/10.1007/s00520-016-3389-6

    Article  PubMed  Google Scholar 

  65. Harrow A, Dryden R, McCowan C et al (2014) A hard pill to swallow: a qualitative study of women’s experiences of adjuvant endocrine therapy for breast cancer. BMJ Open 4:e005285. https://doi.org/10.1136/bmjopen-2014-005285

    Article  PubMed  PubMed Central  Google Scholar 

  66. Simon R, Latreille J, Matte C et al (2014) Adherence to adjuvant endocrine therapy in estrogen receptor-positive breast cancer patients with regular follow-up. Can J Surg 57:26–32. https://doi.org/10.1503/cjs.006211

    Article  PubMed  PubMed Central  Google Scholar 

  67. Wouters H, van Geffen ECG, Baas-Thijssen MC et al (2013) Disentangling breast cancer patients’ perceptions and experiences with regard to endocrine therapy: nature and relevance for non-adherence. Breast 22:661–666. https://doi.org/10.1016/j.breast.2013.05.005

    Article  PubMed  Google Scholar 

  68. Cella D, Fallowfield LJ (2008) Recognition and management of treatment-related side effects for breast cancer patients receiving adjuvant endocrine therapy. Breast Cancer Res Treat 107:167–180. https://doi.org/10.1007/s10549-007-9548-1

    Article  CAS  PubMed  Google Scholar 

  69. Niravath P (2013) Aromatase inhibitor-induced arthralgia: a review. Ann Oncol 24:1443–1449. https://doi.org/10.1093/annonc/mdt037

    Article  CAS  PubMed  Google Scholar 

  70. Walker EM, Rodriguez AI, Kohn B et al (2010) Acupuncture versus venlafaxine for the management of vasomotor symptoms in patients with hormone receptor-positive breast cancer: a randomized controlled trial. J Clin Oncol 28:634–640. https://doi.org/10.1200/JCO.2009.23.5150

    Article  CAS  PubMed  Google Scholar 

  71. Hadji P, Blettner M, Harbeck N et al (2013) The patient’s anastrozole compliance to therapy (PACT) program: a randomized, in-practice study on the impact of a standardized information program on persistence and compliance to adjuvant endocrine therapy in postmenopausal women with early breast cancer. Ann Oncol. https://doi.org/10.1093/annonc/mds653

    Google Scholar 

  72. Neven P, Markopoulos C, Tanner M et al (2014) The impact of educational materials on compliance and persistence rates with adjuvant aromatase inhibitor treatment: first-year results from the compliance of aromatase inhibitors assessment in daily practice through educational approach (CARIATIDE) study. Breast 23:393–399. https://doi.org/10.1016/j.breast.2014.02.009

    Article  PubMed  Google Scholar 

  73. Ziller V, Kyvernitakis I, Knöll D et al (2013) Influence of a patient information program on adherence and persistence with an aromatase inhibitor in breast cancer treatment-the COMPAS study. BMC Cancer 13:407. https://doi.org/10.1186/1471-2407-13-407

    Article  PubMed  PubMed Central  Google Scholar 

  74. Kirchner TR, Shiffman S (2013) Ecological momentary assessment. In: Wiley-Blackwell handbook of addiction psychopharmacology. 10.1002/9781118384404.ch20

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Acknowledgements

LKL was supported by a University of British Columbia Four-Year Fellowship and a CIHR Psychosocial Oncology Research Training (PORT) Fellowship.

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Authors and Affiliations

  1. School of Nursing, University of British Columbia, T201-2211 Wesbrook Mall, Vancouver, BC, V6T 2B5, Canada

    Leah K. Lambert & A. Fuchsia Howard

  2. College of Nursing, Rady Faculty of Health Sciences, Helen Glass Centre for Nursing, University of Manitoba, 89 Curry Place, Winnipeg, MB, R3T 2N2, Canada

    Lynda G. Balneaves

  3. School of Population and Public Health, University of British Columbia, V2206 East Mall, Vancouver, BC, V6T 1Z3, Canada

    Carolyn C. Gotay

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Lambert, L.K., Balneaves, L.G., Howard, A.F. et al. Patient-reported factors associated with adherence to adjuvant endocrine therapy after breast cancer: an integrative review. Breast Cancer Res Treat 167, 615–633 (2018). https://doi.org/10.1007/s10549-017-4561-5

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