Factors Associated with Endocrine Therapy Non-Adherence in Breast Cancer Survivors.


BACKGROUND:For women with hormone receptor positive breast cancer, long-term endocrine therapy (ET) can greatly reduce the risk of recurrence, yet adherence is low- particularly among traditionally underserved populations. METHODS:The Carolina Breast Cancer Study oversampled Black and young women (<50 years of age). Participants answered an ET-specific medication adherence questionnaire assessing reasons for non-adherence. We used principal factor analysis to identify latent factors describing ET non-adherence. We then performed multivariable regression to determine clinical and demographic characteristics associated with each ET non-adherence factor. RESULTS:1,231 women were included in analysis, 59% reported at least one barrier to ET adherence. We identified three latent factors which we defined as: habit - challenges developing medication-taking behavior; tradeoffs - high perceived side effect burden and medication safety concerns; and resource barriers - challenges related to cost or accessibility. Older age (50+) was associated with less reporting of habit (Adjusted Risk Ratio (aRR) 0.54[95% CI: 0.43-0.69] and resource barriers (aRR 0.66[0.43-0.997]), but was not associated with tradeoff barriers. Medicaid-insured women were more likely than privately-insured to report tradeoff (aRR:1.53 [1.10-2.13]) or resource barriers (aRR:4.43[2.49-6.57]). Black race was associated with increased reporting of all factors (habit: aRR 1.29[1.09-1.53]; tradeoffs: 1.32[1.09-1.60], resources: 1.65[1.18-2.30]). CONCLUSION:Barriers to ET adherence were described by three distinct factors, and strongly associated with sociodemographic characteristics. Barriers to ET adherence appear inadequately addressed for younger, Black, and publicly-insured breast cancer survivors. These findings underscore the importance of developing multi-faceted, patient-centered interventions that address a diverse range of barriers to ET adherence.






Spencer JC,Reeve BB,Troester MA,Wheeler SB




Has Abstract


2020-04-01 00:00:00












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    abstract:BACKGROUND:Cancer is a complex health problem requiring multidisciplinary care. There are clinical guidelines available in order to improve the process and outcomes of cancer care within Europe. However, strategic action is still needed in many European Union (EU) Member States to develop or improve national cancer con...


    pub_type: 杂志文章


    authors: Travado L,Reis JC,Watson M,Borràs J

    更新日期:2017-04-01 00:00:00

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    abstract:OBJECTIVES:To explore relationships among perceived diagnostic disclosure, health locus of control, and levels of hope in Taiwanese cancer patients. RESEARCH DESIGN:A cross-sectional, descriptive correlational design was used in this study. One hundred and twenty-four (N=124) patients were recruited. The Background In...


    pub_type: 杂志文章


    authors: Lin CC,Tsay HF

    更新日期:2005-05-01 00:00:00

  • Bereavement outcomes for parents who lose a child to cancer: are place of death and sex of parent associated with differences in psychological functioning?

    abstract::Despite increasing cure rates, cancer is a leading cause of non-accidental death in childhood. Models of psychosocial care in pediatric cancer may therefore need to address bereavement planning for a 'minority group' of parents (approximately 25%) for whom cure of their child is not possible. This study addresses a ga...


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    pub_type: 杂志文章,多中心研究


    authors: Haviland J,Sodergren S,Calman L,Corner J,Din A,Fenlon D,Grimmett C,Richardson A,Smith PW,Winter J,members of Study Advisory Committee.,Foster C

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    authors: Butterfield RM,Park ER,Puleo E,Mertens A,Gritz ER,Li FP,Emmons K

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  • Exploring characteristics, predictors, and consequences of fear of cancer recurrence among Asian-American breast cancer survivors.

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    authors: Ashing KT,Cho D,Lai L,Yeung S,Young L,Yeon C,Fong Y

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    pub_type: 杂志文章


    authors: Weiss T

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    authors: Bloom JR,Stewart SL,Chang S,Banks PJ

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    authors: Kola-Palmer S,Walsh JC

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    pub_type: 杂志文章,评审


    authors: Phillips F

    更新日期:2014-12-01 00:00:00

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    pub_type: 杂志文章


    authors: Salm S,Blaschke K,Ihle P,Schubert I,Dresen A,Pfaff H,Scholten N

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    pub_type: 杂志文章


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    authors: Akechi T,Okuyama T,Akizuki N,Shimizu K,Inagaki M,Fujimori M,Shima Y,Furukawa TA,Uchitomi Y

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    abstract:BACKGROUND:Psychological distress is problematic for patients and their family caregivers in the oncological setting. The level of stress is influenced by the health status of the patient and their family members as well as the support system for home care. However, it remains unclear how best to support distressed car...


    pub_type: 杂志文章


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    更新日期:2016-06-01 00:00:00

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    pub_type: 杂志文章


    authors: Kanani R,Davies EA,Hanchett N,Jack RH

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    pub_type: 杂志文章,多中心研究


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    authors: Dapueto JJ,Francolino C,Gotta I,Levin R,Alonso I,Barrios E,Afonzo Y,Cambiasso S

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    更新日期:2006-08-01 00:00:00