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

Publication ,  Journal Article
Spencer, JC; Reeve, BB; Troester, MA; Wheeler, SB
Published in: Psychooncology
April 2020

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.

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Published In

Psychooncology

DOI

EISSN

1099-1611

Publication Date

April 2020

Volume

29

Issue

4

Start / End Page

647 / 654

Location

England

Related Subject Headings

  • Surveys and Questionnaires
  • Oncology & Carcinogenesis
  • Middle Aged
  • Medication Adherence
  • Humans
  • Female
  • Cancer Survivors
  • Breast Neoplasms
  • Black or African American
  • Antineoplastic Agents, Hormonal
 

Citation

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Spencer, J. C., Reeve, B. B., Troester, M. A., & Wheeler, S. B. (2020). Factors Associated with Endocrine Therapy Non-Adherence in Breast Cancer Survivors. Psychooncology, 29(4), 647–654. https://doi.org/10.1002/pon.5289
Spencer, Jennifer C., Bryce B. Reeve, Melissa A. Troester, and Stephanie B. Wheeler. “Factors Associated with Endocrine Therapy Non-Adherence in Breast Cancer Survivors.Psychooncology 29, no. 4 (April 2020): 647–54. https://doi.org/10.1002/pon.5289.
Spencer JC, Reeve BB, Troester MA, Wheeler SB. Factors Associated with Endocrine Therapy Non-Adherence in Breast Cancer Survivors. Psychooncology. 2020 Apr;29(4):647–54.
Spencer, Jennifer C., et al. “Factors Associated with Endocrine Therapy Non-Adherence in Breast Cancer Survivors.Psychooncology, vol. 29, no. 4, Apr. 2020, pp. 647–54. Pubmed, doi:10.1002/pon.5289.
Spencer JC, Reeve BB, Troester MA, Wheeler SB. Factors Associated with Endocrine Therapy Non-Adherence in Breast Cancer Survivors. Psychooncology. 2020 Apr;29(4):647–654.
Journal cover image

Published In

Psychooncology

DOI

EISSN

1099-1611

Publication Date

April 2020

Volume

29

Issue

4

Start / End Page

647 / 654

Location

England

Related Subject Headings

  • Surveys and Questionnaires
  • Oncology & Carcinogenesis
  • Middle Aged
  • Medication Adherence
  • Humans
  • Female
  • Cancer Survivors
  • Breast Neoplasms
  • Black or African American
  • Antineoplastic Agents, Hormonal