Barriers to and facilitative processes of endocrine therapy adherence among women with breast cancer
- 631 Downloads
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.
KeywordsBreast 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.
- 3.Burstein HJ, Temin S, Anderson H, Buchholz A, Davidson NE, Gelmon KE, Griggs JJ (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 32:2255–2269CrossRefPubMedPubMedCentralGoogle Scholar
- 18.Gonzales JS, Batchelder A, Psaros C, Safren SA (2011) Depression and HIV/AIDS treatment nonadherence: a review and meta-analysis. J AIDS 58(2):181–187Google Scholar
- 23.Zivian MT, Salgado B. Side effects revisited: women’s experiences with aromatase inhibitors. Breast Cancer Action. 145. 525–534. http://archive.bcaction.org/uploads/PDF/AIReport.pdf
- 28.Haynes RB, Sackett DL (1979) Compliance in health care. Johns Hopkins University Press, BaltimoreGoogle Scholar