Johanna Wassermann1,2, Shari I Gelber1, Shoshana M Rosenberg1, Kathryn J Ruddy3, Rulla M Tamimi4, Lidia Schapira5, Virginia F Borges6, Steven E Come7, Meghan E Meyer1, Ann H Partridge1. 1. Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts. 2. Pierre Louis Institute of Epidemiology and Public Health, Sorbonne University, French National Institute of Health and Medical Research, Paris, France. 3. Department of Oncology, Mayo Clinic, Rochester, Minnesota. 4. Department of Medicine, Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, Massachusetts. 5. Department of Medicine, Stanford Cancer Institute, Palo Alto, California. 6. Division of Medical Oncology, Department of Medicine, University of Colorado Cancer Center, Aurora, Colorado. 7. Division of Medical Oncology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
Abstract
BACKGROUND: Young age is a known factor associated with suboptimal adherence to endocrine therapy (ET) for adjuvant breast cancer (BC) treatment. This study was aimed at assessing nonadherent behaviors and associated factors among young women with early-stage hormone receptor-positive BC. METHODS: As part of a multicenter, prospective cohort of women with a diagnosis of BC at or under the age of 40 years, participants were surveyed 30 months after their diagnosis about adherent behaviors. Among those who reported taking ET, adherence was measured with a 3-item Likert-type scale: Do you ever forget to take your ET? If you feel worse when you take your ET, do you stop taking it? Did you take your ET exactly as directed by your doctor over the last 3 months? Women reporting at least 1 nonadherent behavior were classified as nonadherers. Variables with a P value <.20 were included in a multivariable logistic model. RESULTS: Among 384 women, 194 (51%) were classified as nonadherers. Univariate factors that retained significance in the multivariable model included educational level (odds ratio [OR], 0.50 for high vs low; P = .04), level of social support according to the Medical Outcome Study Social Support Survey (OR, 0.98 per 1 point; P = .01), and confidence with the decision regarding ET measured on a 0 to 10 numerical scale (OR, 0.63 for high vs low; P = .04). CONCLUSIONS: Findings from this study could help to identify young patients at higher risk for nonadherence. Interventions adapted to the level of education and aimed at reinforcing support and patients' confidence in their decision to take ET could improve adherence and associated outcomes in this population.
BACKGROUND: Young age is a known factor associated with suboptimal adherence to endocrine therapy (ET) for adjuvant breast cancer (BC) treatment. This study was aimed at assessing nonadherent behaviors and associated factors among young women with early-stage hormone receptor-positive BC. METHODS: As part of a multicenter, prospective cohort of women with a diagnosis of BC at or under the age of 40 years, participants were surveyed 30 months after their diagnosis about adherent behaviors. Among those who reported taking ET, adherence was measured with a 3-item Likert-type scale: Do you ever forget to take your ET? If you feel worse when you take your ET, do you stop taking it? Did you take your ET exactly as directed by your doctor over the last 3 months? Women reporting at least 1 nonadherent behavior were classified as nonadherers. Variables with a P value <.20 were included in a multivariable logistic model. RESULTS: Among 384 women, 194 (51%) were classified as nonadherers. Univariate factors that retained significance in the multivariable model included educational level (odds ratio [OR], 0.50 for high vs low; P = .04), level of social support according to the Medical Outcome Study Social Support Survey (OR, 0.98 per 1 point; P = .01), and confidence with the decision regarding ET measured on a 0 to 10 numerical scale (OR, 0.63 for high vs low; P = .04). CONCLUSIONS: Findings from this study could help to identify young patients at higher risk for nonadherence. Interventions adapted to the level of education and aimed at reinforcing support and patients' confidence in their decision to take ET could improve adherence and associated outcomes in this population.
Authors: Miryam Yusufov; Margo Nathan; Aleta Wiley; Julia Russell; Ann Partridge; Hadine Joffe Journal: Breast Cancer Res Treat Date: 2020-09-12 Impact factor: 4.872
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Authors: Tal Sella; Philip D Poorvu; Kathryn J Ruddy; Shari I Gelber; Rulla M Tamimi; Jeffrey M Peppercorn; Lidia Schapira; Virginia F Borges; Steven E Come; Ann H Partridge; Shoshana M Rosenberg Journal: Cancer Date: 2021-04-22 Impact factor: 6.921
Authors: Lindsay J Collin; Deirdre P Cronin-Fenton; Thomas P Ahern; Michael Goodman; Lauren E McCullough; Lance A Waller; Anders Kjærsgaard; Per Damkier; Peer M Christiansen; Bent Ejlertsen; Maj-Britt Jensen; Henrik Toft Sørensen; Timothy L Lash Journal: Clin Cancer Res Date: 2020-12-17 Impact factor: 13.801
Authors: Jamie M Jacobs; Emily A Walsh; Chelsea S Rapoport; Michael H Antoni; Elyse R Park; Kathryn Post; Amy Comander; Jeffrey Peppercorn; Steven A Safren; Jennifer S Temel; Joseph A Greer Journal: J Clin Psychol Med Settings Date: 2020-11-21