Breast Cancer Research and Treatment

, Volume 169, Issue 1, pp 153–162 | Cite as

Adjuvant hormonal therapy for early breast cancer: an epidemiologic study of medication adherence

  • Charlotte Pourcelot
  • Emeline Orillard
  • Gilles Nallet
  • Camille Dirand
  • François Billion-Rey
  • Garance Barbier
  • Sarah Chouk
  • Samuel Limat
  • Philippe Montcuquet
  • Julie Henriques
  • Sophie Paget-Bailly
  • Amélie Anota
  • Loïc Chaigneau
  • Virginie Nerich



The aim of this study was to determine the prevalence of adherence to adjuvant hormonal therapy (AHT) and to identify risk factors for medication non-adherence in clinical practice in patients with early-stage hormone receptor (HR)-positive breast cancer (BC) previously treated with chemotherapy.


We carried out a cross-sectional, observational, prospective, and multicenter survey based on a structured self-report postal questionnaire (35 items investigating six areas). A sample of 474 patients was drawn from 676 patients potentially eligible. The structured and validated Morisky Medication Adherence Scale-4 items was used for measuring medication adherence. An analysis of risk factors for non-adherence to AHT was performed using a two-step approach: univariate, then multivariate analysis.


A total of 280 patients out of the 428 analyzed patients participated in the survey, yielding a response rate of 65.4% [60.9–69.9]. The prevalence of adherence to AHT was estimated at 68.6% [63.1–74.0], corresponding to a high level of adherence. Three risk factors for non-adherence to AHT were identified: > 2 medications to treat comorbidities (p-value = 0.003), age less than 65 years (p-value = 0.008), and patient management in a university hospital setting (p-value = 0.014).


Non-adherence is a common, complex, and multidimensional healthcare problem. This better understanding and knowledge of risk factors will allow healthcare providers (such as oncologists, general practitioners, pharmacists) to more easily identify patients at risk for non-adherence and help them provide appropriate information about AHT and its management, thus improving medication adherence in their patients.


Adjuvant hormonal therapy Aromatase inhibitors Breast cancer Medication adherence Tamoxifen 



We would like to thank all patients, pharmacists and oncologists of the IRFC-FC participating in this study. We also thank Ms Pamela Albert for English assistance in the correction of the manuscript.


No sources of funding were used to assist in the preparation of this article.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest related to the content of this manuscript.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Charlotte Pourcelot
    • 1
  • Emeline Orillard
    • 2
  • Gilles Nallet
    • 3
    • 4
  • Camille Dirand
    • 1
  • François Billion-Rey
    • 5
  • Garance Barbier
    • 1
  • Sarah Chouk
    • 1
  • Samuel Limat
    • 1
    • 6
  • Philippe Montcuquet
    • 2
  • Julie Henriques
    • 6
    • 7
  • Sophie Paget-Bailly
    • 6
    • 7
  • Amélie Anota
    • 6
    • 7
  • Loïc Chaigneau
    • 2
  • Virginie Nerich
    • 1
    • 6
  1. 1.Department of PharmacyBesançon University HospitalBesançon CedexFrance
  2. 2.Department of Medical OncologyBesançon University HospitalBesançon CedexFrance
  3. 3.Federative Regional Institute for Cancer of Franche-ComtéBesançon CedexFrance
  4. 4.ONCOLIE Network of CancerBesançon CedexFrance
  5. 5.Department of PharmacyLons-le-Saunier HospitalLons Le SaunierFrance
  6. 6.University of Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, Interactions hôte-greffon-tumeur – Ingénierie Cellulaire et GéniqueBesançon CedexFrance
  7. 7.Besançon University Hospital, Methodological and Quality of Life in Cancerology UnitUniversity of Bourgogne Franche-ComtéBesançonFrance

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