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01-10-2016 | Original Article

Barriers and facilitators to endocrine therapy adherence among underserved hormone-receptor-positive breast cancer survivors: a qualitative study

Authors: Kristen J. Wells, Tonya M. Pan, Coralia Vázquez-Otero, Danielle Ung, Amy E. Ustjanauskas, Dariana Muñoz, Christine Laronga, Richard G. Roetzheim, Marissa Goldenstein, Claudia Carrizosa, Sumayah Nuhaily, Kenneth Johnson, Marilyn Norton, Elizabeth Sims, Gwendolyn P. Quinn

Published in: Supportive Care in Cancer | Issue 10/2016

Abstract

Purpose

To evaluate the barriers and facilitators to taking anti-hormonal medications among medically and historically underserved breast cancer survivors within the first 5 years post chemotherapy, radiation, and/or surgery.

Methods

The current study was framed within the National Institutes of Health Centers for Population Health and Health Disparities Model (NIHCPHHD Model). Twenty-five historically or medically underserved breast cancer survivors participated in an in-depth interview, in either English or Spanish. Interviews were audio recorded and transcribed verbatim. Interview data were analyzed using content analysis.

Results

Anti-hormonal medication adherence was facilitated in several ways, including establishing a routine of medication taking, leaving the medicine in a visible or easily accessible place, taking the medication with other medications, reducing the cost of medicine, using a pillbox, understanding the negative consequences of lack of adherence, and having positive interactions with physicians. Side effects were the most commonly mentioned barrier to medication adherence.

Conclusions

Similar to other research, this qualitative study of medically and historically underserved breast cancer survivors in the USA found that side effects are the most frequently endorsed barrier to anti-hormonal medication adherence. Conversely, there were a number of facilitators of correct and consistent anti-hormonal medication use. The management of side effects is critically important to increase adherence to anti-hormonal medications. Health care providers, support providers, and caregivers can encourage breast cancer survivors to better adhere to anti-hormonal medications using a number of approaches that have been successful for other women.

Howlader N, Noone AM, Krapcho M, Garshell J, Miller D, Altekruse SF, Kosary CL, Yu M, Ruhl J, Tatalovich Z, Mariotto A, Lewis DR, Chen HS, Feuer EJ, Cronin KA (eds). SEER Cancer Statistics Review, 1975-2011, National Cancer Institute. Bethesda, MD, http://seer.cancer.gov/csr/1975_2011/, based on November 2013 SEER data submission, posted to the SEER web site, April 2014

Siegel R, DeSantis C, Virgo K, Stein K, Mariotto A, Smith T et al (2012) Cancer treatment and survivorship statistics, 2012. CA Cancer J Clin 62:220–41CrossRefPubMed

Hammond MEH, Hayes DF, Dowsett M, Allred DC, Hagerty KL, Badve S et al (2010) American Society of Clinical Oncology/College of American Pathologists guideline recommendations for immunohistochemical testing of estrogen and progesterone receptors in breast cancer. J Clin Oncol 28:2784–95CrossRefPubMedPubMedCentral

National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology. Breast Cancer V.2.2010. 2010 [cited 2010 Mar 16]; Available from: http://www.nccn.org

Winer EP (2004) American Society of Clinical Oncology Technology assessment on the use of aromatase inhibitors as adjuvant therapy for postmenopausal women with hormone receptor-positive breast cancer: status report 2004. J Clin Oncol 23:619–29CrossRefPubMed

Hershman DL, Kushi LH, Shao T, Buono D, Kershenbaum A, Tsai W-Y et al (2010) Early discontinuation and nonadherence to adjuvant hormonal therapy in a cohort of 8,769 early-stage breast cancer patients. J Clin Oncol 28:4120–8CrossRefPubMedPubMedCentral

American Cancer Society (2013) Breast cancer facts & figures 2013-2014. Atlanta: American Cancer Society, Inc.

Rao RD, Cobleigh MA (2012) Adjuvant endocrine therapy for breast cancer. Oncology 26:541–7PubMed

Doggrell SA (2011) Adherence to oral endocrine treatments in women with breast cancer: can it be improved? Breast Cancer Res Treat 129:299–308CrossRefPubMed

10.

Lash TL, Fox MP, Buist DSM, Wei F, Field TS, Frost FJ et al (2007) Mammography surveillance and mortality in older breast cancer survivors. J Clin Oncol 25:3001–6CrossRefPubMed

11.

Abe O, Abe R, Enomoto KT, Kikuchi K, Koyama H, Nomura Y et al (1998) Tamoxifen for early breast cancer: an overview of the randomised trials. Lancet 351:1451–67CrossRef

12.

Schiavon G, Smith IE (2014) Status of adjuvant endocrine therapy for breast cancer. Breast Cancer Res 16:206CrossRefPubMedPubMedCentral

13.

Murphy CC, Bartholomew LK, Carpentier MY, Bluethmann SM, Vernon SW (2012) Adherence to adjuvant hormonal therapy among breast cancer survivors in clinical practice: a systematic review. Breast Cancer Res Treat 134:459–78CrossRefPubMedPubMedCentral

14.

Huiart L, Ferdynus C, Giorgi R (2013) A meta-regression analysis of the available data on adherence to adjuvant hormonal therapy in breast cancer: summarizing the data for clinicians. Breast Cancer Res Treat 138:325–8CrossRefPubMed

15.

Reynolds KL, Higgins MJ (2013) Endocrine therapy for breast cancer: a tough pill to swallow. Menopause 20:714–6CrossRefPubMed

16.

Henry NL, Azzouz F, Desta Z, Li L, Nguyen AT, Lemler S et al (2012) Predictors of aromatase inhibitor discontinuation as a result of treatment-emergent symptoms in early-stage breast cancer. J Clin Oncol 30:936–42CrossRefPubMedPubMedCentral

17.

Burstein HJ, Prestrud AA, Seidenfeld J, Anderson H, Buchholz TA, Davidson NE et al (2010) American Society of Clinical Oncology Clinical Practice Guideline: update on adjuvant endocrine therapy for women with hormone receptor-positive breast cancer. J Clin Oncol 28:3784–96CrossRefPubMed

18.

Simon R, Latreille J, Matte C, Desjardins P, Bergeron E (2014) Adherence to adjuvant endocrine therapy in estrogen receptor–positive breast cancer patients with regular follow-up. Can J Surg 57:26–32CrossRefPubMedPubMedCentral

19.

Hadji P (2010) Improving compliance and persistence to adjuvant tamoxifen and aromatase inhibitor therapy. Crit Rev Oncol Hematol 73:156–66CrossRefPubMed

20.

Lash TL, Fox MP, Westrup JL, Fink AK, Silliman RA (2006) Adherence to tamoxifen over the five-year course. Breast Cancer Res Treat 99:215–20CrossRefPubMed

21.

Van Liew JR, Christensen AJ, de Moor JS (2014) Psychosocial factors in adjuvant hormone therapy for breast cancer: an emerging context for adherence research. J Cancer Surviv 8(3):521–31. doi:10.1007/s11764-014-0374-2 CrossRefPubMed

22.

Pellegrini I, Sarradon-Eck A, Ben Soussan P, Lacour A-C, Largillier R, Tallet A et al (2010) Women’s perceptions and experience of adjuvant tamoxifen therapy account for their adherence: breast cancer patients’ point of view. Psychooncology 19:472–9CrossRefPubMed

23.

Harrow A, Dryden R, McCowan C, Radley A, Parsons M, Thompson AM et al (2014) A hard pill to swallow: a qualitative study of women’s experiences of adjuvant endocrine therapy for breast cancer. BMJ Open 4, e005285CrossRefPubMedPubMedCentral

24.

Warnecke RB, Oh A, Breen N, Gehlert S, Paskett E, Tucker KL et al (2008) Approaching health disparities from a population perspective: The National Institutes of Health Centers for Population Health and Health Disparities. Am J Public Health 98:1608–15CrossRefPubMedPubMedCentral

25.

Patton M. Qualitative Research and Evaluation Methods (2002) Sage Publications, London

26.

ATLAS.ti [Internet]. Berlin: Scientific Software Development GmbH; 2010. Available from: http://www.atlasti.com/index.html

27.

Knodel J (1993) The design and analysis of focus group studies: a practical approach. Success. Focus Groups Adv. State Art. London: Sage Publications. p. 35–50

28.

Borg W, Gall M (1989) Educational research: an introduction. Longman, New York

29.

Krueger R (1998) Moderating Focus Groups. Sage Publications, Thousand OaksCrossRef

30.

IBM SPSS Statistics Version 20. IBM Corporation, 2011.

31.

Zullig LL, Peterson ED, Bosworth HB (2013) Ingredients of successful interventions to improve medication adherence. JAMA 310:2611–2CrossRefPubMed

32.

The Cochrane Collaboration, editor. Cochrane Database of Systematic Reviews: Protocols [Internet]. Chichester, UK: John Wiley & Sons, Ltd; 1996 [cited 2014 Jul 28]. Available from: http://doi.wiley.com/10.1002/14651858

Title: Barriers and facilitators to endocrine therapy adherence among underserved hormone-receptor-positive breast cancer survivors: a qualitative study
Authors: Kristen J. Wells
Tonya M. Pan
Coralia Vázquez-Otero
Danielle Ung
Amy E. Ustjanauskas
Dariana Muñoz
Christine Laronga
Richard G. Roetzheim
Marissa Goldenstein
Claudia Carrizosa
Sumayah Nuhaily
Kenneth Johnson
Marilyn Norton
Elizabeth Sims
Gwendolyn P. Quinn
Publication date: 01-10-2016
Publisher: Springer Berlin Heidelberg
Published in: Supportive Care in Cancer / Issue 10/2016
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-016-3229-8

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Abstract

Purpose

Methods

Results

Conclusions

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