Identifying socio-demographic and clinical characteristics associated with medication beliefs about aromatase inhibitors among postmenopausal women with breast cancer
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Non-adherence/persistence to adjuvant endocrine therapy can negatively impact survival. Beliefs about medicines are known to affect adherence. This study aims to identify socio-demographic and clinical characteristics associated with medication beliefs among women taking aromatase inhibitors (AIs).
Women completed an online survey on beliefs about AI therapy [Beliefs about Medicines Questionnaire (BMQ)], beliefs about breast cancer [Assessment of Survivor Concerns scale (ASC)], and depression [Personal Health Questionnaire depression scale (PHQ-8)]. Socio-demographic and clinical characteristics were collected. Bivariate analyses and linear regression models were performed to investigate relationships between variables.
A total of 224 women reported currently taking AI therapy and were included in the analysis. Significantly higher concern beliefs were found among women who had at least mild depression, experienced side effects from AIs, and previously stopped therapy with another AI. Significant correlations were found between concern and necessity beliefs and cancer and health worry. Women age 70 and older displayed less fear of cancer recurrence and health worry, and a trend towards lower necessity and concern beliefs. No differences were found for other variables. In the regression model, greater necessity beliefs were found with increases in the number of current prescription medications (B = 1.06, 95% CI 0.31–1.81, p = 0.006) and shorter duration of current AI therapy (B = −0.65, 95% CI −1.23 to −0.07, p = 0.029), whereas greater concern beliefs were associated with higher depression scores (B = 1.19, 95% CI 0.35–2.03, p = 0.006).
Medication necessity and concern beliefs were associated with a definable subset of patients who may be at higher risk for non-persistence.
KeywordsMedication adherence Adjuvant endocrine therapy Aromatase inhibitor Beliefs about medicines Socio-demographic characteristics Persistence
Dr. Henry was supported, in part, by a Damon Runyon-Lilly Clinical Investigator Award supported by the Damon Runyon Cancer Research Foundation (#CI-53-10).
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
This study was approved by the University of Michigan (UM) Institutional Review Board (IRBMED). Written informed consent was obtained from all individuals before completing the survey.
- 2.Burstein HJ, Temin S, Anderson H, Buchholz TA, Davidson NE, Gelmon KE, Giordano SH, Hudis CA, Rowden D, Solky AJ 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 32:2255–2269CrossRefPubMedPubMedCentralGoogle Scholar
- 7.Chirgwin JH, Giobbie-Hurder A, Coates AS, Price KN, Ejlertsen B, Debled M, Gelber RD, Goldhirsch A, Smith I, Rabaglio M et al (2016) Treatment adherence and its impact on disease-free survival in the breast international group 1-98 trial of tamoxifen and letrozole, alone and in sequence. J Clin Oncol 34:2452–2459CrossRefPubMedGoogle Scholar
- 8.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 126:529–537CrossRefPubMedGoogle Scholar
- 16.Kumar K, Raza K, Nightingale P, Horne R, Chapman S, Greenfield S, Gill P (2015) Determinants of adherence to disease modifying anti-rheumatic drugs in White British and South Asian patients with rheumatoid arthritis: a cross sectional study. BMC Musculoskelet Disord 16:396CrossRefPubMedPubMedCentralGoogle Scholar
- 23.Partridge AH, Fasse K, Stanton AL, Jones A, Bright E, Petrie KJ (2015) What goes through your mind when you think about your medication? Thoughts about endocrine medication and treatment adherence (Publication Number: P5-12-13). San Antonio Breast Cancer Symposium: 2015 San Antonio, TXGoogle Scholar
- 27.Neugut AI, Hillyer GC, Kushi LH, Lamerato L, Leoce N, Nathanson SD, Ambrosone CB, Bovbjerg DH, Mandelblatt JS, Magai C et al (2012) Non-initiation of adjuvant hormonal therapy in women with hormone receptor-positive breast cancer: the breast cancer quality of care study (BQUAL). Breast Cancer Res Treat 134:419–428CrossRefPubMedPubMedCentralGoogle Scholar
- 28.Wouters H, Stiggelbout AM, Bouvy ML, Maatman GA, Van Geffen EC, Vree R, Nortier JW, Van Dijk L (2014) Endocrine therapy for breast cancer: assessing an array of women’s treatment experiences and perceptions, their perceived self-efficacy and non adherence. Clin Breast Cancer 14(460–467):e462Google Scholar
- 31.Kumar K, Gordon C, Toescu V, Buckley CD, Horne R, Nightingale PG, Raza K (2008) Beliefs about medicines in patients with rheumatoid arthritis and systemic lupus erythematosus: a comparison between patients of South Asian and White British origin. Rheumatology (Oxford) 47:690–697CrossRefGoogle Scholar
- 46.Greenlee H, Neugut AI, Falci L, Hillyer GC, Buono D, Roh JM, Ergas IJ, Kwan ML, Lee M, Tsai WY et al (2015) Complementary and alternative medicine use and breast cancer chemotherapy initiation: The BQUAL study (Publication Number: PD4-05). San Antonio Breast Cancer Symposium: 2015 San Antonio, TXGoogle Scholar
- 47.Huiart L, Bouhnik AD, Rey D, Rousseau F, Retornaz F, Meresse M, Bendiane MK, Viens P, Giorgi R (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:e81677CrossRefPubMedPubMedCentralGoogle Scholar
- 48.Hadji P, Blettner M, Harbeck N, Jackisch C, Luck HJ, Windemuth-Kieselbach C, Zaun S, Kreienberg R (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 24:1505–1512CrossRefPubMedGoogle Scholar