Interruption and Non-Adherence to Long-Term Adjuvant Hormone Therapy Is Associated with Adverse Survival Outcome of Breast Cancer Women - An Asian Population-Based Study

Hsieh, Kun-Pin; Chen, Li‐Chia; Cheung, Kwok-Leung; Chang, Chao-Sung; Yang, Yi‐Hsin

doi:10.1371/journal.pone.0087027

Cited by 62 publications

(71 citation statements)

References 18 publications

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“…(4) Furthermore, there is growing data showing that better adherence to endocrine therapy leads to higher survival rates. (7–9) Interventions that help patients adhere to prescribed endocrine therapy are needed.…”

Section: Inroductionmentioning

confidence: 99%

Medication taking behaviors among breast cancer patients on adjuvant endocrine therapy

et al. 2015

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Purpose To explore how symptoms and psychosocial factors are related to intentional and unintentional non-adherent medication taking behaviors. Methods Included were postmenopausal women with hormone receptor positive, stage I-IIIA breast cancer, who had completed surgery, chemotherapy, and radiation, and were taking endocrine therapy. Self-administered, standardized measures were completed during a routine clinic visit: Brief Fatigue Inventory, Brief Pain Inventory, Menopause Specific Quality of Life Questionnaire, Functional Assessment of Cancer Therapy General and Neurotoxicity scales, and Self-Efficacy for Appropriate Medication Use Scale. Regression analyses were performed to determine the degree to which demographic, medical, symptom, and psychosocial variables, explain intentional, such as changing one’s doses or stopping medication, and unintentional, such as forgetting to take one’s medication, non-adherent behaviors. Results Participants were 112 women: mean age 64 (SD=9) years; 81% white; mean time from surgery 40 (SD=28) months; 49% received chemotherapy (39% including a taxane); mean time on endocrine therapy, 35 (SD=29.6) months; 82% taking an aromatase inhibitor. Intentional and unintentional non-adherent behaviors were described in 33.9% and 58.9% of participants, respectively. Multivariate analysis showed that higher self-efficacy for taking medication was associated with lower levels of unintentional (p=0.002) and intentional (p=0.004) non-adherent behaviors. The presence of symptoms (p=0.03) and lower self-efficacy for physician communication (p=0.009) were associated with higher levels of intentional non-adherent behaviors. Conclusions These results suggest that women who report greater symptoms, lower self-efficacy for communicating with their physician, and lower self-efficacy for taking their medication are more likely to engage in both intentional and unintentional non-adherent behaviors.

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Section: Inroductionmentioning

confidence: 99%

Medication taking behaviors among breast cancer patients on adjuvant endocrine therapy

et al. 2015

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“…Discontinuation or treatment interruption of hormone therapy (HT) may lead to an increase in breast cancer (BC) mortality . However, concerns have been raised by several studies that reported a suboptimal adherence and persistence to HT in BC patients .…”

Section: Introductionmentioning

confidence: 99%

A competing risk analysis of hormone therapy interruption in Asian women with breast cancer

Hsieh

Chen

Cheung

et al. 2014

Pharmacoepidemiology and Drug

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The competing risk approach provided lower probabilities and estimates when investigating the incidence of first interruption than the standard survival analysis. The competing risk method, which takes into account the competing risks from cancer recurrence and death, should be considered in future analysis. In terms of improving persistence of HT, it is important to focus on patients of younger age at diagnosis, HT switching and experiencing adverse events.

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“…The included studies focussed on a wide range of disease areas including pulmonary diseases, osteoporosis, depression, cardiovascular diseases, Parkinson's disease, epilepsy, chronic kidney disease, cancer and diabetes mellitus . Two studies did not measure disease‐specific medication (non‐)adherence .…”

Section: Resultsmentioning

confidence: 99%

The association between medication non‐adherence and adverse health outcomes in ageing populations: A systematic review and meta‐analysis

Walsh

Cahir

Tecklenborg

et al. 2019

Brit J Clinical Pharma

148

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Aims The aim of this systematic review and meta‐analysis was to synthesise the evidence relating to medication non‐adherence and its association with health outcomes in people aged ≥50 years. Methods Seven databases were searched up to February 2019 for observational studies that measured medication (non‐)adherence as a predictor of the following health outcomes in adults aged ≥50 years: healthcare utilisation (hospitalisation, emergency department visits, outpatient visits and general practitioner visits), mortality, adverse clinical events and quality of life. Screening and quality assessment using validated criteria were completed by 2 reviewers independently. Random effects models were used to generate pooled estimates of association using adjusted study results. The full methodological approach was published on PROSPERO (ID: CRD42017077264). Results Sixty‐six studies were identified for qualitative synthesis, with 11 of these studies eligible for meta‐analyses. A meta‐analysis including 3 studies measuring medication non‐adherence in adults aged ≥55 years showed a significant association with all‐cause hospitalisation (adjusted odds ratio 1.17, 95% confidence interval [CI] 1.12, 1.21). A meta‐analysis including 2 studies showed that medication non‐adherence was not significantly associated with an emergency department visit (adjusted odds ratio 1.05, 95% CI 0.90, 1.22). Good adherence was associated with a 21% reduction in long‐term mortality risk in comparison to medication non‐adherence (adjusted hazard ratio 0.79, 95% CI 0.63, 0.98). Conclusion Medication non‐adherence may be significantly associated with all‐cause hospitalisation and mortality in older people. Medication adherence should be monitored and addressed in this cohort to minimise hospitalisation, improve clinical outcomes and reduce healthcare costs.

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Interruption and Non-Adherence to Long-Term Adjuvant Hormone Therapy Is Associated with Adverse Survival Outcome of Breast Cancer Women - An Asian Population-Based Study

Cited by 62 publications

References 18 publications

Medication taking behaviors among breast cancer patients on adjuvant endocrine therapy

Medication taking behaviors among breast cancer patients on adjuvant endocrine therapy

A competing risk analysis of hormone therapy interruption in Asian women with breast cancer

The association between medication non‐adherence and adverse health outcomes in ageing populations: A systematic review and meta‐analysis

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