Adherence in tamoxifen therapy after conversion to a rebate pharmaceutical in breast cancer patients in Germany

Kostev, Karel; May, Uwe; Hog, Daniela; Eisel, Janine; Kremmers, Tim; Kosteic, Marjan; Waehlert, Lilia; Hadji, Peyman

doi:10.5414/cp201969

Cited by 13 publications

(16 citation statements)

References 17 publications

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“…Five studies showed that odds of persistence increased by 21%–66% if treatment was received by an oncologist or a gynecologist as opposed to a general practitioner, 32 , 43 – 45 , 53 while two studies found no significant effect. Five studies found that being prescribed more medications per month was associated with increased odds of persistence; 7 , 25 , 26 , 54 , 55 however, an additional study showed the opposite effect 32 and three studies found no significant effects.…”

Section: Resultsmentioning

confidence: 97%

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Barriers and facilitators of adjuvant hormone therapy adherence and persistence in women with breast cancer: a systematic review

Moon

Moss‐Morris²,

Hunter³

et al. 2017

PPA

120

207

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PurposeNonadherence to hormone therapy in breast cancer survivors is common and associated with increased risk of mortality. Consistent predictors of nonadherence and nonpersistence are yet to be identified, and little research has examined psychosocial factors that may be amenable to change through intervention. This review aimed to identify predictors of nonadherence and nonpersistence to hormone therapy in breast cancer survivors in order to inform development of an intervention to increase adherence rates.MethodsStudies published up to April 2016 were identified through MEDLINE, Embase, Web of Science, PsycINFO, CINAHL and gray literature. Studies published in English measuring associations between adherence or persistence and any predictor variables were included. Eligible studies were assessed for methodological quality, data were extracted and a narrative synthesis was conducted.ResultsSixty-one eligible articles were identified. Most studies focused on clinical and demographic factors with inconsistent results. Some evidence suggested that receiving specialist care and social support were related to increased persistence, younger age and increased number of hospitalizations were associated with nonadherence, and good patient–physician relationship and self-efficacy for taking medication were associated with better adherence. A small amount of evidence suggested that medication beliefs were associated with adherence, but more high-quality research is needed to confirm this.ConclusionSome psychosocial variables were associated with better adherence and persistence, but the results are currently tentative. Future high-quality research should be carried out to identify psychosocial determinants of nonadherence or nonpersistence that are modifiable through intervention.

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Section: Resultsmentioning

confidence: 97%

“…Three studies found that a codiagnosis of osteoporosis or diabetes was related to increased persistence. 43 – 45 However, mixed results were found for the effects of comorbidities in general, with the majority of studies finding no significant associations.…”

Section: Resultsmentioning

confidence: 99%

Barriers and facilitators of adjuvant hormone therapy adherence and persistence in women with breast cancer: a systematic review

Moon

Moss‐Morris²,

Hunter³

et al. 2017

PPA

120

207

View full text Add to dashboard Cite

show abstract

“…This study suggested that side effects can cause women to discontinue treatment, which has been shown in several quantitative studies (Demissie et al ., ; Simon, Latreille, Matte, Desjardins, & Bergeron, ; Wouters et al ., ). However, there is an inconsistent relationship between side effects and adherence, with some studies finding no significant effects (Fink et al ., ; Kostev et al ., ). The results from this study suggest that adherence is not just related to the experience of side effects, but how women weigh these up against their beliefs; that is that just the experience of side effects is not sufficient to cause non‐adherence.…”

Section: Discussionmentioning

confidence: 97%

Understanding tamoxifen adherence in women with breast cancer: A qualitative study

Moon

Moss‐Morris

Hunter

et al. 2017

British J Health Psychol

101

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Women who believed that the necessity of tamoxifen outweighed its costs were more likely to be adherent, whereas women who thought that the benefits did not outweigh the side effects were more likely to have discontinued. A third more ambivalent group believed strongly in the importance of treatment, but were struggling with side effects and were often non-adherent. Patients sometimes felt unsupported and discussed a need for more comprehensive information. To increase adherence, future research needs to explore ways to increase beliefs around tamoxifen necessity and how to help women cope with side effects. Statement of contribution What is already known on this subject? Non-adherence to tamoxifen is associated with increased risk of recurrence and mortality. Up to 50% of patients are non-adherent to tamoxifen by the fifth year of treatment Few consistent predictors of tamoxifen non-adherence have been identified. What does this study add? Many women report not knowing how to manage their side effects. Non-adherence is related to how women weigh up their side effects against their medication beliefs. Interventions aiming to increase necessity beliefs and improve symptom management may be effective.

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“…Another point to be mentioned is the introduction of rebate contracts in the German healthcare system, which has not only significantly increased the level of bureaucracy in pharmacies but also posed a range of new patient safety risks. [28][29][30] Therefore, a new tool was introduced in 2008, enabling pharmacists and PTAs to deny substitution of the prescribed medicine by raising pharmaceutical concerns about rebate contract product's dosage form appropriateness, its potential negative impact on patient's adherence, etc. 18 However, the risk of abstaining from using the aforementioned tool when necessary was rated rather highly.…”

Section: Discussionmentioning

confidence: 99%

Prospective systemic risk analysis of the dispensing process in German community pharmacies

Stojković

Rose

Woltersdorf

et al. 2017

Health Planning & Management

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Adherence in tamoxifen therapy after conversion to a rebate pharmaceutical in breast cancer patients in Germany

Cited by 13 publications

References 17 publications

Barriers and facilitators of adjuvant hormone therapy adherence and persistence in women with breast cancer: a systematic review

Barriers and facilitators of adjuvant hormone therapy adherence and persistence in women with breast cancer: a systematic review

Understanding tamoxifen adherence in women with breast cancer: A qualitative study

Prospective systemic risk analysis of the dispensing process in German community pharmacies

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