Perceptions of Endocrine Therapy in African-American Breast Cancer Survivors: Mixed Methods Study

Donevant, Sara B; Heiney, Sue P.; Wineglass, Cassandra; Schooley, Benjamin; Singh, Akanksha; Sheng, Jingxi

doi:10.2196/23884

Cited by 6 publications

(5 citation statements)

References 48 publications

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“…The most common barrier to OET adherence reported by patients and physicians is adverse drug reactions [ 50 – 52 ]. African American women more often report postmenopausal symptoms and joint pain with OET than Caucasians [ 53 , 54 ]. They also more often believe that their recurrence risk would not change if they stopped OET and report forgetting to take it regularly [ 53 – 56 ].…”

Section: Discussionmentioning

confidence: 99%

“…African American women more often report postmenopausal symptoms and joint pain with OET than Caucasians [ 53 , 54 ]. They also more often believe that their recurrence risk would not change if they stopped OET and report forgetting to take it regularly [ 53 – 56 ]. Therefore, patient-centered interventions addressing these key barriers to OET adherence in African American women, especially those with low SES, are urgently needed.…”

Section: Discussionmentioning

confidence: 99%

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Adherence to oral endocrine therapy in racial/ethnic minority patients with low socioeconomic status before and during the COVID-19 pandemic

et al. 2023

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Background Adherence to oral endocrine therapy (OET) is crucial in ensuring its maximum benefit in the prevention and treatment of hormone receptor-positive (HR +) breast cancer (BC). Medication use behavior is suboptimal especially in racial/ethnic minorities with lower socioeconomic status (SES). Aim We aimed to assess the impact of the coronavirus disease 2019 (COVID-19) pandemic on OET adherence and identify demographic and/or clinical characteristics associated with nonadherence in racial/ethnic minorities with lower SES. Method A retrospective study was conducted at the Harris Health System in Houston, Texas. Data were collected during the 6 months before and 6 months after the start of the pandemic. The adherence was assessed using the prescription refill data using the proportion of days covered. A multivariable logistic regression model was used to identify demographic/clinical characteristics associated with nonadherence. Eighteen years or older patients on appropriate doses of OET for prevention or treatment of BC were included. Results In 258 patients, adherence was significantly lower during the pandemic (44%) compared to before the pandemic (57%). The demographic/clinical characteristics associated with OET nonadherence before the pandemic were Black/African American, obesity/extreme obesity, prevention setting, tamoxifen therapy, and 4 or more years on OET. During the pandemic, prevention setting and those not using home delivery were more likely to be nonadherent. Conclusion OET adherence was significantly reduced during the COVID-19 pandemic in racial/ethnic minority patients with low SES. Patient-centered interventions are necessary to improve OET adherence in these patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Adherence to oral endocrine therapy in racial/ethnic minority patients with low socioeconomic status before and during the COVID-19 pandemic

et al. 2023

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“…The main reasons for this difference are not clear. The differences in treatment compliance and inherent genetic predisposition may lead to differences in survival between the 2 ethnic groups [32][33][34][35].…”

Section: Discussionmentioning

confidence: 99%

Stage-Specific Survival in Breast Cancer in Chinese and White Women: Comparative Data Analysis

Wang¹,

Zhou²,

Liu³

et al. 2022

JMIR Public Health Surveill

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Background Stage-specific survival, according to the eighth edition of the American Joint Committee on Cancer (AJCC) pathological prognostic staging (PPS) on breast cancer (BC), between Chinese and White American women remains unclear. Objective This study aimed to assess stage-specific survival in BC between Chinese and White American women according to the eighth AJCC PPS. Methods We included Chinese and White American women with BC diagnosed between 2010 and 2018 from the Surveillance, Epidemiology, and End Results database. A chi-square test, the Kaplan–Meier method, a receiver operating characteristic (ROC) curve, and multivariate Cox proportional hazards models were used for data analysis. Results We included 376,818 individuals in this study: 369,522 White American and 7296 Chinese. Of them, 149,452 (39.7%) migrated from the seventh AJCC anatomic staging (AS) to the eighth AJCC PPS, 22,516 (6.0%) were upstaged, and 126,936 (33.7%) were downstaged. With a median follow-up duration of 44 months, the 5-year overall survival and cancer-specific survival (CSS) for the entire group were 87.4% and 95.9%, respectively. The seventh AJCC AS (P<.001) and the eighth AJCC PPS (P<.001) could significantly predict the survival outcomes of BC, and multivariate analysis revealed that both staging systems were significant prognostic indicators of CSS. The ROC curve revealed that the PPS had a better discriminating ability than the AS (area under the curve [AUC] 0.769 vs 0.753, P<.001). Similar trends were observed after stratification by the 2 ethnic groups. The eighth AJCC PPS had better discriminating ability than the seventh AJCC AS among both White American (AUC 0.769 vs 0.753, P<.001) and Chinese patients (AUC 0.790 vs 0.776, P<.001). In the seventh AJCC AS, Chinese women had better CSS in stage IA (P=.02), stage IIA (P=.005), and stage IIIB (P=.04) disease than White American women, but no significant CSS was observed in stage IB, IIB, IIIA, and IIIC disease between the 2 ethnic groups. Regarding the eighth AJCC PPS, Chinese women had better CSS in stage IA (P=.002) and IIIA (P=.046) disease than White American women, and CSS was similar in Chinese and White American women in other substages. Conclusions The eighth AJCC PPS has a similar discriminative ability between White American and Chinese individuals with BC compared with the seventh AJCC AS. Therefore, the eighth AJCC PPS is also applicable to Chinese individuals with BC.

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“…The most common barrier to OET adherence reported by patients and physicians is adverse drug reactions [46][47][48]. African American women more often report postmenopausal symptoms and joint pain with OET than Caucasians [49,50]. They also more often believe that their recurrence risk would not change if they stopped OET and report forgetting to take it regularly [51,49,52,50].…”

Section: Discussionmentioning

confidence: 99%

“…African American women more often report postmenopausal symptoms and joint pain with OET than Caucasians [49,50]. They also more often believe that their recurrence risk would not change if they stopped OET and report forgetting to take it regularly [51,49,52,50]. Therefore, patient-centered interventions addressing these key barriers to OET adherence in African American women, especially those of low SES, are urgently needed.…”

Section: Discussionmentioning

confidence: 99%

Identifying the predictors of adherence to oral endocrine therapy in racial/ethnic minority patients with low socioeconomic status

Rahimi

Ononogbu

Mohan

et al. 2022

Preprint

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Background Adherence to oral endocrine therapy (OET) is crucial in ensuring its maximum benefit in prevention and treatment of hormone receptor-positive (HR+) breast cancer (BC) in patients. Medication use behavior is suboptimal especially in racial/ethnic minorities of lower socioeconomic status (SES). We aimed to assess the OET adherence and its predictors in racial/ethnic minority patients of lower SES. Aim We aimed to assess the OET adherence and determine the predictors of OET nonadherence in racial/ethnic minority patients of lower SES. Method A retrospective study was conducted at the Harris Health System in Houston, Texas. Since the study period included the COVID-19 pandemic, data was collected during the 6 months prior and 6 months after the start of the pandemic. The adherence was assessed using the prescription refill data using the proportion of days covered. Multivariable logistic regression model was used to identify predictors of nonadherence. Eighteen years or older patients on appropriate doses of OET for prevention or treatment of BC were included. Result In 258 patients, the adherence was significantly lower during the pandemic (44%) compared to before the pandemic (57%). The predictors of OET nonadherence before the pandemic were Black/African American, obesity/extreme obesity, prevention setting, tamoxifen therapy, and 4 or more years on OET. During the pandemic, prevention setting and those not using home delivery were more likely to be nonadherent. Conclusion Racial/ethnic minority patients of lower SES, especially African Americans and those using OET for prevention of BC, require individualized interventions to improve adherence.

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Perceptions of Endocrine Therapy in African-American Breast Cancer Survivors: Mixed Methods Study

Cited by 6 publications

References 48 publications

Adherence to oral endocrine therapy in racial/ethnic minority patients with low socioeconomic status before and during the COVID-19 pandemic

Adherence to oral endocrine therapy in racial/ethnic minority patients with low socioeconomic status before and during the COVID-19 pandemic

Stage-Specific Survival in Breast Cancer in Chinese and White Women: Comparative Data Analysis

Identifying the predictors of adherence to oral endocrine therapy in racial/ethnic minority patients with low socioeconomic status

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