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Breast Cancer Research and Treatment

, Volume 152, Issue 2, pp 239–246 | Cite as

Depression as a predictor of adherence to adjuvant endocrine therapy (AET) in women with breast cancer: a systematic review and meta-analysis

  • Brent T. MausbachEmail author
  • Richard B. Schwab
  • Scott A. Irwin
Review

Abstract

The purpose of this meta-analysis was to analyze the available evidence concerning the effects of depression on non-adherence to adjuvant endocrine therapy (AET) in women with breast cancer. MEDLINE and PsycInfo databases from inception through May 1, 2015 were searched using terms related to AET adherence. Articles were reviewed and selected based on predetermined selection criteria, and effect sizes from included studies were extracted. Pooled effect estimates were obtained using random-effects meta-analyses. Of the 312 articles identified, 9 met the inclusion criteria. Overall, depression was significantly associated with non-adherence to AET (Cohen’s d = 0.35, 95 % CI 0.19–0.52). This effect was not significantly moderated by patient age (<65 vs ≥65 years), length of study follow-up (<18 months vs ≥18 months), or method of assessing adherence (objective vs self-report). However, within these subgroups, significant effects of depression were found only for younger patients (d = 0.46; 95 % CI 0.19–0.72) and in studies of shorter duration (<18 months) (d = 0.49; 95 % CI 0.22–0.76). These results suggest that AET adherence may be lower among women with greater depressive symptoms, and this effect may be exacerbated in younger women during the early phases (<18 months) of AET. Management of depressive symptoms in women with breast cancer may help in enhancing adherence to AET and improve cancer treatment outcomes.

Keywords

Mood Tamoxifen Aromatase inhibitor Mental illness Estrogen therapy Outcomes 

Notes

Conflict of interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    Kessler RC, Bromet EJ (2013) The epidemiology of depression across cultures. Annu Rev Public Health 34:119–138. doi: 10.1146/annurev-publhealth-031912-114409 PubMedCentralPubMedCrossRefGoogle Scholar
  2. 2.
    Krebber AM, Buffart LM, Kleijn G, Riepma IC, de Bree R, Leemans CR, Becker A, Brug J, van Straten A, Cuijpers P, Verdonck-de Leeuw IM (2014) Prevalence of depression in cancer patients: a meta-analysis of diagnostic interviews and self-report instruments. Psychooncology 23:121–130. doi: 10.1002/pon.3409 PubMedCentralPubMedCrossRefGoogle Scholar
  3. 3.
    Sachs G, Rasoul-Rockenschaub S, Aschauer H, Spiess K, Gober I, Staffen A, Zielinski C (1995) Lytic effector cell activity and major depressive disorder in patients with breast cancer: a prospective study. J Neuroimmunol 59:83–89. doi: 10.1016/0165-5728(95)00029-2 PubMedCrossRefGoogle Scholar
  4. 4.
    Watson M, Haviland JS, Greer S, Davidson J, Bliss JM (1999) Influence of psychological response on survival in breast cancer: a population-based cohort study. Lancet 354:1331–1336. doi: 10.1016/S0140-6736(98)11392-2 PubMedCrossRefGoogle Scholar
  5. 5.
    Pinquart M, Duberstein PR (2010) Depression and cancer mortality: a meta-analysis. Psychol Med 40:1797–1810. doi: 10.1017/S0033291709992285 PubMedCentralPubMedCrossRefGoogle Scholar
  6. 6.
    Davies C, Pan H, Godwin J, Gray R, Arriagada R, Raina V, Abraham M, Medeiros Alencar VH, Badran A, Bonfill X, Bradbury J, Clarke M, Collins R, Davis SR, Delmestri A, Forbes JF, Haddad P, Hou MF, Inbar M, Khaled H, Kielanowska J, Kwan WH, Mathew BS, Mittra I, Muller B, Nicolucci A, Peralta O, Pernas F, Petruzelka L, Pienkowski T, Radhika R, Rajan B, Rubach MT, Tort S, Urrutia G, Valentini M, Wang Y, Peto R (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. doi: 10.1016/S0140-6736(12)61963-1 PubMedCentralPubMedCrossRefGoogle Scholar
  7. 7.
    Hershman DL, Shao T, Kushi LH, Buono D, Tsai WY, Fehrenbacher L, Kwan M, Gomez SL, Neugut AI (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. doi: 10.1007/s10549-010-1132-4 PubMedCentralPubMedCrossRefGoogle Scholar
  8. 8.
    Ma AM, Barone J, Wallis AE, Wu NJ, Garcia LB, Estabrook A, Rosenbaum-Smith SM, Tartter PI (2008) Noncompliance with adjuvant radiation, chemotherapy, or hormonal therapy in breast cancer patients. Am J Surg 196:500–504. doi: 10.1016/j.amjsurg.2008.06.027 PubMedCrossRefGoogle Scholar
  9. 9.
    Partridge AH, Wang PS, Winer EP, Avorn J (2003) Nonadherence to adjuvant tamoxifen therapy in women with primary breast cancer. J Clin Oncol 21:602–606. doi: 10.1200/JCO.2003.07.071 PubMedCrossRefGoogle Scholar
  10. 10.
    Brito C, Portela MC, de Vasconcellos MT (2014) Adherence to hormone therapy among women with breast cancer. BMC Cancer 14:397. doi: 10.1186/1471-2407-14-397 PubMedCentralPubMedCrossRefGoogle Scholar
  11. 11.
    Kemp A, Preen DB, Saunders C, Boyle F, Bulsara M, Malacova E, Roughead EE (2014) Early discontinuation of endocrine therapy for breast cancer: who is at risk in clinical practice? SpringerPlus 3:282. doi: 10.1186/2193-1801-3-282 PubMedCentralPubMedCrossRefGoogle Scholar
  12. 12.
    Lebovits AH, Strain JJ, Schleifer SJ, Tanaka JS, Bhardwaj S, Messe MR (1990) Patient noncompliance with self-administered chemotherapy. Cancer 65:17–22. doi: 10.1002/1097-0142(19900101)65:1<17:AID-CNCR2820650106>3.0.CO;2-I PubMedCrossRefGoogle Scholar
  13. 13.
    Hedges LV, Olkin I (1985) Statistical methods for meta-analysis. Academic Press, New YorkGoogle Scholar
  14. 14.
    Lipsey MW, Wilson DB (2001) Practical meta analysis. Sage, Thousand OaksGoogle Scholar
  15. 15.
    Bax L, Yu LM, Ikeda N, Tsuruta H, Moons KGM (2006) Development and validation of MIX: comprehensive free software for meta-analysis of causal research data. BMC Med Res Methodol 6:50PubMedCentralPubMedCrossRefGoogle Scholar
  16. 16.
    Rosenthal R (1979) The file drawer problem and tolerance for null results. Psychol Bull 86:638–641. doi: 10.1037/0033-2909.86.3.638 CrossRefGoogle Scholar
  17. 17.
    Egger M, Smith GD, Schneider M, Minder C (1997) Bias in meta-analysis detected by a simple, graphical test. BMJ 315:629–634. doi: 10.1136/bmj.315.7109.629 PubMedCentralPubMedCrossRefGoogle Scholar
  18. 18.
    Wilson DB (2010) Meta-analysis macros for SAS, SPSS, and Stata. http://mason.gmu.edu/~dwilsonb/ma.html. Accessed 21 Aug 2010
  19. 19.
    Borenstein M, Hedges LV, Higgins JPT, Rothstein HR (2009) Introduction to meta-analysis. Wiley, ChichesterCrossRefGoogle Scholar
  20. 20.
    Uthman OA, Magidson JF, Safren SA, Nachega JB (2014) Depression and adherence to antiretroviral therapy in low-, middle- and high-income countries: a systematic review and meta-analysis. Curr HIV/AIDS Rep 11:291–307. doi: 10.1007/s11904-014-0220-1 PubMedCrossRefGoogle Scholar
  21. 21.
    Gentil L, Vasiliadis HM, Preville M, Bosse C, Berbiche D (2012) Association between depressive and anxiety disorders and adherence to antihypertensive medication in community-living elderly adults. J Am Geriatr Soc 60:2297–2301. doi: 10.1111/j.1532-5415.2012.04239.x PubMedCrossRefGoogle Scholar
  22. 22.
    Lin EH, Katon W, Von Korff M, Rutter C, Simon GE, Oliver M, Ciechanowski P, Ludman EJ, Bush T, Young B (2004) Relationship of depression and diabetes self-care, medication adherence, and preventive care. Diabetes Care 27:2154–2160. doi: 10.2337/diacare.27.9.2154 PubMedCrossRefGoogle Scholar
  23. 23.
    Wells JS, Strickland OL, Dalton JA, Freeman S (2015) Adherence to intravenous chemotherapy in African American and white women with early-stage breast cancer. Cancer Nurs 38:89–98. doi: 10.1097/NCC.0000000000000139 PubMedCrossRefGoogle Scholar
  24. 24.
    Gilbar O, De-Nour AK (1989) Adjustment to illness and dropout of chemotherapy. J Psychosom Res 33:1–5. doi: 10.1016/0022-3999(89)90100-1 PubMedCrossRefGoogle Scholar
  25. 25.
    Barron TI, Connolly R, Bennett K, Feely J, Kennedy MJ (2007) Early discontinuation of tamoxifen: a lesson for oncologists. Cancer 109:832–839. doi: 10.1002/cncr.22485 PubMedCrossRefGoogle Scholar
  26. 26.
    Hershman DL, Kushi LH, Shao T, Buono D, Kershenbaum A, Tsai WY, Fehrenbacher L, Gomez SL, Miles S, Neugut AI (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. doi: 10.1200/JCO.2009.25.9655 PubMedCentralPubMedCrossRefGoogle Scholar
  27. 27.
    Wirtz HS, Boudreau DM, Gralow JR, Barlow WE, Gray S, Bowles EJ, Buist DS (2014) Factors associated with long-term adherence to annual surveillance mammography among breast cancer survivors. Breast Cancer Res Treat 143:541–550. doi: 10.1007/s10549-013-2816-3 PubMedCentralPubMedCrossRefGoogle Scholar
  28. 28.
    Early Breast Cancer Trialists’ Collaborative Group (2005) Effects of chemotherapy and hormonal therapy for early breast cancer on recurrence and 15-year survival: an overview of the randomised trials. Lancet 365:1687–1717. doi: 10.1016/S0140-6736(05)66544-0 CrossRefGoogle Scholar
  29. 29.
    Kroenke K (2003) Patients presenting with somatic complaints: epidemiology, psychiatric comorbidity and management. Int J Methods Psychiatr Res 12:34–43. doi: 10.1002/mpr.140 PubMedCrossRefGoogle Scholar
  30. 30.
    Luber MP, Meyers BS, Williams-Russo PG, Hollenberg JP, DiDomenico TN, Charlson ME, Alexopoulos GS (2001) Depression and service utilization in elderly primary care patients. Am J Geriatr Psychiatry 9:169–176. doi: 10.1176/appi.ajgp.9.2.169 PubMedCrossRefGoogle Scholar
  31. 31.
    Badger TA, Braden CJ, Mishel MH (2001) Depression burden, self-help interventions, and side effect experience in women receiving treatment for breast cancer. Oncol Nurs Forum 28:567–574PubMedGoogle Scholar
  32. 32.
    Weidenbacher HJ, Beadles CA, Maciejewski ML, Reeve BB, Voils CI (2015) Extent and reasons for nonadherence to antihypertensive, cholesterol, and diabetes medications: the association with depressive symptom burden in a sample of American veterans. Patient Prefer Adherence 9:327–336. doi: 10.2147/PPA.S74531 PubMedCentralPubMedCrossRefGoogle Scholar
  33. 33.
    Huang AX, Delucchi K, Dunn LB, Nelson JC (2015) A systematic review and meta-analysis of psychotherapy for late-life depression. Am J Geriatr Psychiatry 23:261–273. doi: 10.1016/j.jagp.2014.04.003 PubMedCrossRefGoogle Scholar
  34. 34.
    Cuijpers P, Berking M, Andersson G, Quigley L, Kleiboer A, Dobson KS (2013) A meta-analysis of cognitive-behavioural therapy for adult depression, alone and in comparison with other treatments. Can J Psychiatry 58:376–385PubMedGoogle Scholar
  35. 35.
    Cipriani A, Furukawa TA, Salanti G, Geddes JR, Higgins JP, Churchill R, Watanabe N, Nakagawa A, Omori IM, McGuire H, Tansella M, Barbui C (2009) Comparative efficacy and acceptability of 12 new-generation antidepressants: a multiple-treatments meta-analysis. Lancet 373:746–758. doi: 10.1016/S0140-6736(09)60046-5 PubMedCrossRefGoogle Scholar
  36. 36.
    Hart SL, Hoyt MA, Diefenbach M, Anderson DR, Kilbourn KM, Craft LL, Steel JL, Cuijpers P, Mohr DC, Berendsen M, Spring B, Stanton AL (2012) Meta-analysis of efficacy of interventions for elevated depressive symptoms in adults diagnosed with cancer. J Natl Cancer Inst 104:990–1004. doi: 10.1093/jnci/djs256 PubMedCentralPubMedCrossRefGoogle Scholar
  37. 37.
    Laoutidis ZG, Mathiak K (2013) Antidepressants in the treatment of depression/depressive symptoms in cancer patients: a systematic review and meta-analysis. BMC Psychiatry 13:140. doi: 10.1186/1471-244X-13-140 PubMedCentralPubMedCrossRefGoogle Scholar
  38. 38.
    McCowan C, Wang S, Thompson AM, Makubate B, Petrie DJ (2013) The value of high adherence to tamoxifen in women with breast cancer: a community-based cohort study. Br J Cancer 109:1172–1180. doi: 10.1038/bjc.2013.464 PubMedCentralPubMedCrossRefGoogle Scholar
  39. 39.
    Bender CM, Gentry AL, Brufsky AM, Casillo FE, Cohen SM, Dailey MM, Donovan HS, Dunbar-Jacob J, Jankowitz RC, Rosenzweig MQ, Sherwood PR, Sereika SM (2014) Influence of patient and treatment factors on adherence to adjuvant endocrine therapy in breast cancer. Oncol Nurs Forum 41:274–285. doi: 10.1188/14.ONF.274-285 PubMedCentralPubMedCrossRefGoogle Scholar
  40. 40.
    Cluze C, Rey D, Huiart L, BenDiane MK, Bouhnik AD, Berenger C, Carrieri MP, Giorgi R (2012) Adjuvant endocrine therapy with tamoxifen in young women with breast cancer: determinants of interruptions vary over time. Ann Oncol 23:882–890. doi: 10.1093/annonc/mdr330 PubMedCrossRefGoogle Scholar
  41. 41.
    Fink AK, Gurwitz J, Rakowski W, Guadagnoli E, Silliman RA (2004) Patient beliefs and tamoxifen discontinuance in older women with estrogen receptor–positive breast cancer. J Clin Oncol 22:3309–3315. doi: 10.1200/JCO.2004.11.064 PubMedCrossRefGoogle Scholar
  42. 42.
    Kidwell KM, Harte SE, Hayes DF, Storniolo AM, Carpenter J, Flockhart DA, Stearns V, Clauw DJ, Williams DA, Henry NL (2014) Patient-reported symptoms and discontinuation of adjuvant aromatase inhibitor therapy. Cancer 120:2403–2411. doi: 10.1002/cncr.28756 PubMedCrossRefGoogle Scholar
  43. 43.
    Klepin HD, Geiger AM, Bandos H, Costantino JP, Rapp SR, Sink KM, Lawrence JA, Atkinson HH, Espeland MA (2014) Cognitive factors associated with adherence to oral antiestrogen therapy: results from the cognition in the study of tamoxifen and raloxifene (Co-STAR) study. Cancer Prev Res 7:161–168. doi: 10.1158/1940-6207.CAPR-13-0165 CrossRefGoogle Scholar
  44. 44.
    Lash TL, Fox MP, Westrup JL, Fink AK, Silliman RA (2006) Adherence to tamoxifen over the five-year course. Breast Cancer Res Treat 99:215–220. doi: 10.1007/s10549-006-9193-0 PubMedCrossRefGoogle Scholar
  45. 45.
    Manning M, Bettencourt BA (2011) Depression and medication adherence among breast cancer survivors: bridging the gap with the theory of planned behaviour. Psychol Health 26:1173–1187. doi: 10.1080/08870446.2010.542815 PubMedCrossRefGoogle Scholar
  46. 46.
    Sedjo RL, Devine S (2011) Predictors of non-adherence to aromatase inhibitors among commercially insured women with breast cancer. Breast Cancer Res Treat 125:191–200. doi: 10.1007/s10549-010-0952-6 PubMedCrossRefGoogle Scholar
  47. 47.
    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. doi: 10.1007/s10549-014-2961-3 PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  1. 1.Department of PsychiatryUniversity of California San DiegoLa JollaUSA
  2. 2.Moores Cancer CenterUniversity of California San Diego Healthcare SystemLa JollaUSA
  3. 3.Division of Hematology/Oncology, Department of MedicineUniversity of California San DiegoLa JollaUSA

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