Kaitlyn D’Onofrio

DocwireNews

A new study examined factors associated with non-adherence to endocrine therapy among <a href="https://www.docwirenews.com/docwire-pick/hem-onc-picks/acceptance-and-commitment-therapy-may-reduce-fear-of-recurrence-in-cancer-survivors/">breast cancer</a> patients.&ldquo;For women with hormone receptor positive <a href="https://www.docwirenews.com/docwire-pick/hem-onc-picks/breast-cancer-death-rates-continue-to-decline-but-at-a-slower-pace/">breast cancer</a>, long&#8208;term endocrine therapy (ET) can greatly reduce the risk of recurrence, yet adherence is low&#8208; particularly among traditionally underserved populations,&rdquo; the study authors established.The study, which was published in <a href="https://onlinelibrary.wiley.com/doi/abs/10.1002/pon.5289">Psycho-Oncology</a>, examined data from the Carolina Breast Cancer Study, which included an oversample of black women and women aged younger than 50 years. Patients filled out a survey related to their endocrine therapy medication adherence, particularly assessing the reasons for non-adherence. Principal factor analysis was used to establish latent factors that indicated non-adherence, and multivariable regression was used to identify which characteristics&mdash;both demographic and clinical&mdash;predictive of each endocrine therapy non-adherence factor.Final analysis included 1,231 women. Of the total cohort, more than half (59%) identified at least one obstacle that kept them from adhering to endocrine therapy. Three latent factors were observed, which the researchers defined as barriers associated with:<ul>
<li>Habit (challenges developing medication&#8208;taking behavior)</li>
<li>Tradeoff (high perceived side effect burden and medication safety concerns)</li>
<li>Resource (challenges related to cost or accessibility)</li>
</ul>Women who were aged 50 years and older were less likely to report habit (adjusted risk ratio [aRR]=0.54; 95% confidence interval [CI], 0.43&ndash;0.69) and resource (aRR=0.66; 95% CI, 0.43&ndash;0.99) barriers, but older age was not correlated with tradeoff barriers. Women who were insured through Medicaid, compared to those with private insurance, were more likely to report tradeoff (aRR=1.53; 95% CI, 1.10&ndash;2.13) or resource (aRR=4.43; 95% CI, 2.49&ndash;6.57) barriers. Black women were more likely to report all three barriers: habit (aRR=1.29; 95% CI, 1.09&ndash;1.53), tradeoff (aRR=1.32; 95% CI, 1.09&ndash;1.60), and resource (aRR=4.43; 95% CI, 2.49&ndash;6.57).&ldquo;Endocrine therapy can offer a big benefit for breast cancer survivors, but many of the strategies we use to help women who are struggling with medication adherence are only designed to address one barrier at a time,&rdquo; said Jennifer Spencer, PhD, of the University of North Carolina at Chapel Hill, lead author of the study, <a href="https://www.eurekalert.org/pub_releases/2020-02/w-cfl021920.php">in a press release</a>. &ldquo;Our study finds that there are at least three distinct kinds of barriers that women might experience when taking endocrine therapy&ndash;suggesting that intervention strategies that can help address multiple barriers at once might be more effective, especially for Black women.&rdquo;The authors summarized, &ldquo;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&#8208;insured breast cancer survivors. These findings underscore the importance of developing multi&#8208;faceted, patient&#8208;centered interventions that address a diverse range of barriers to ET adherence.&rdquo;

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A new study examined factors associated with non-adherence to endocrine therapy among breast cancer patients. ...

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