A study in the Journal of Oncology Pharmacy Practice sought to identify factors that contribute to nonadherence to endocrine therapy in breast-cancer treatment plans.
Researchers from the Department of Pharmaceutical Science at Harding University College of Pharmacy in Searcy, Arkansas, surveyed 32 women with a breast-cancer diagnosis.
The pharmacists and pharmacy students conducting the study focused on patient-related factors (e.g., patient personal beliefs, education level), drug-related factors (e.g., patient drug allergies), socioeconomic factors (e.g., patient ability to pay for the medication), and healthcare system factors (e.g., poor patient-healthcare provider relationship) that could lead to nonadherence.
The study team measured medication adherence rates using the Medication Adherence Rating Scale system. Researchers also looked at associations between adherence rate scores and the clinical variables, including age, tobacco use, alcohol consumption, cost of treatment, education level, personal beliefs, drug allergies, patient/provider relationship, and adverse events.
Results indicated that 59% of survey respondents were nonadherent to their endocrine therapy in breast-cancer treatment plans. Factors affecting nonadherence were found to be drug allergies (P = .000069), patient ability to pay (P = .005), poor personal beliefs about the prescribed therapy (P = 0.009), low education level (P = .025), adverse drug events (P = .026), and poor patient-provider relationship (P = .05).
“Our study found that drug, (e.g., allergies), socioeconomic (e.g., patient ability to pay), and patient-related factors (e.g., personal beliefs) are the strongest predictors of adherence among breast cancer patients undergoing endocrine therapy,” the authors write. “These findings support the need for a better relationship between breast cancer patients and their healthcare providers, including drug experts such as pharmacists.”
A United Kingdom study published at about the same time in the journal Breast emphasized the impact of adverse-drug events on adherence. The meta-analysis concludes that hormone therapy “side effects significantly impact breast cancer survivor’s quality of life. A lack of support from healthcare providers leads to self-management strategies, which negatively affects adherence and persistence behavior.”
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