Arden L Corter1, Reuben Broom2, David Porter2, Vernon Harvey2, Michael Findlay3. 1. Department of Psychological Medicine, University of Auckland, Auckland, New Zealand. 2. Medical Oncology Department, Auckland City Hospital, Auckland, New Zealand. 3. Discipline of Oncology, Oncology, Auckland, New Zealand.
Abstract
BACKGROUND: Failing to take endocrine therapy (ET) as prescribed (nonadherence) increases risk of morbidity and mortality from breast cancer recurrence. We explored predictors of nonadherence, including demographic, clinical, treatment, and personal factors, among women newly prescribed ET for early stage breast cancer. We also examined predictors of their thoughts about stopping treatment (TST). METHODS: A baseline survey prior to ET assessed demographics, illness beliefs, beliefs about medicines, fear of recurrence, symptoms, and negative affect. A follow-up survey at 3 months repeated these measures with additional questions about nonadherence and TST. Nonadherence and TST were analyzed using logistic and multiple regression, respectively. Patient record review provided clinical data. The baseline survey was completed by 125 women, with a 96% retention rate at follow-up. RESULTS: Thirty-six percent reported nonadherence, and 30% reported TST. Results of regression analyses showed that TST was most strongly associated with symptom severity at follow-up, whereas, lower coherence beliefs, and the absence of comorbid conditions were the strongest predictors of actual nonadherence. CONCLUSION: This is the first longitudinal study to examine concurrently the association of demographic, personal and treatment factors with nonadherence, and TST. Findings have potentially important clinical implications; interventions to improve adherence and reduce TST may need to target women's understanding of their diagnosis and treatment, illness beliefs, and symptoms prior to starting therapy.
BACKGROUND: Failing to take endocrine therapy (ET) as prescribed (nonadherence) increases risk of morbidity and mortality from breast cancer recurrence. We explored predictors of nonadherence, including demographic, clinical, treatment, and personal factors, among women newly prescribed ET for early stage breast cancer. We also examined predictors of their thoughts about stopping treatment (TST). METHODS: A baseline survey prior to ET assessed demographics, illness beliefs, beliefs about medicines, fear of recurrence, symptoms, and negative affect. A follow-up survey at 3 months repeated these measures with additional questions about nonadherence and TST. Nonadherence and TST were analyzed using logistic and multiple regression, respectively. Patient record review provided clinical data. The baseline survey was completed by 125 women, with a 96% retention rate at follow-up. RESULTS: Thirty-six percent reported nonadherence, and 30% reported TST. Results of regression analyses showed that TST was most strongly associated with symptom severity at follow-up, whereas, lower coherence beliefs, and the absence of comorbid conditions were the strongest predictors of actual nonadherence. CONCLUSION: This is the first longitudinal study to examine concurrently the association of demographic, personal and treatment factors with nonadherence, and TST. Findings have potentially important clinical implications; interventions to improve adherence and reduce TST may need to target women's understanding of their diagnosis and treatment, illness beliefs, and symptoms prior to starting therapy.
Authors: Yvonne L Luigjes-Huizer; Nina M Tauber; Gerry Humphris; Nadine A Kasparian; Wendy W T Lam; Sophie Lebel; Sébastien Simard; Allan Ben Smith; Robert Zachariae; Yati Afiyanti; Katy J L Bell; José A E Custers; Niek J de Wit; Peter L Fisher; Jacqueline Galica; Sheila N Garland; Charles W Helsper; Mette M Jeppesen; Jianlin Liu; Roxana Mititelu; Evelyn M Monninkhof; Lahiru Russell; Josée Savard; Anne E M Speckens; Sanne J van Helmondt; Sina Vatandoust; Nicholas Zdenkowski; Marije L van der Lee Journal: Psychooncology Date: 2022-04-07 Impact factor: 3.955