Breast Cancer Research and Treatment

, Volume 158, Issue 2, pp 243–251 | Cite as

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

  • Emma E. BrightEmail author
  • Keith J. Petrie
  • Ann H. Partridge
  • Annette L. StantonEmail author
Preclinical study


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.


Breast cancer Adherence Tamoxifen Aromatase inhibitor Compliance Barriers 



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

Compliance with ethical standards

Conflicts of interests

The authors declare that they have no conflict of interest.


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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  1. 1.Department of PsychologyUniversity of CaliforniaLos AngelesUSA
  2. 2.Department of Psychological MedicineUniversity of AucklandAucklandNew Zealand
  3. 3.Dana-Farber Cancer Institute, Brigham and Women’s Hospital, Harvard Medical SchoolBostonUSA
  4. 4.Departments of Psychology and Psychiatry/Biobehavioral Sciences, Center for Cancer Prevention and Control Research, Jonsson Comprehensive Cancer CenterUniversity of CaliforniaLos AngelesUSA

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