Nonadherent behaviors among young women on adjuvant endocrine therapy for breast cancer

Johanna Wassermann, Shari I. Gelber, Shoshana M. Rosenberg, Kathryn J Ruddy, Rulla M. Tamimi, Lidia Schapira, Virginia F. Borges, Steven E. Come, Meghan E. Meyer, Ann H. Partridge

Research output: Contribution to journalArticle

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.

Original languageEnglish (US)
JournalCancer
DOIs
StatePublished - Jan 1 2019

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Breast Neoplasms
Odds Ratio
Therapeutics
Social Support
Educational Models
Logistic Models
Outcome Assessment (Health Care)
Hormones
Education
Population

Keywords

  • antineoplastic agents
  • breast neoplasms
  • hormonal
  • medication adherence
  • patient compliance
  • tamoxifen
  • young women

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Wassermann, J., Gelber, S. I., Rosenberg, S. M., Ruddy, K. J., Tamimi, R. M., Schapira, L., ... Partridge, A. H. (2019). Nonadherent behaviors among young women on adjuvant endocrine therapy for breast cancer. Cancer. https://doi.org/10.1002/cncr.32192

Nonadherent behaviors among young women on adjuvant endocrine therapy for breast cancer. / Wassermann, Johanna; Gelber, Shari I.; Rosenberg, Shoshana M.; Ruddy, Kathryn J; Tamimi, Rulla M.; Schapira, Lidia; Borges, Virginia F.; Come, Steven E.; Meyer, Meghan E.; Partridge, Ann H.

In: Cancer, 01.01.2019.

Research output: Contribution to journalArticle

Wassermann, J, Gelber, SI, Rosenberg, SM, Ruddy, KJ, Tamimi, RM, Schapira, L, Borges, VF, Come, SE, Meyer, ME & Partridge, AH 2019, 'Nonadherent behaviors among young women on adjuvant endocrine therapy for breast cancer', Cancer. https://doi.org/10.1002/cncr.32192
Wassermann, Johanna ; Gelber, Shari I. ; Rosenberg, Shoshana M. ; Ruddy, Kathryn J ; Tamimi, Rulla M. ; Schapira, Lidia ; Borges, Virginia F. ; Come, Steven E. ; Meyer, Meghan E. ; Partridge, Ann H. / Nonadherent behaviors among young women on adjuvant endocrine therapy for breast cancer. In: Cancer. 2019.
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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.",
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AU - Gelber, Shari I.

AU - Rosenberg, Shoshana M.

AU - Ruddy, Kathryn J

AU - Tamimi, Rulla M.

AU - Schapira, Lidia

AU - Borges, Virginia F.

AU - Come, Steven E.

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AB - 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.

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KW - hormonal

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KW - tamoxifen

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