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

  • Epidemiology
  • Published:
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Abstract

Purpose

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.

Methods

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.

Results

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).

Conclusions

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.

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Acknowledgements

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.

Funding

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

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Authors and Affiliations

  1. Department of Pharmacy, Besançon University Hospital, Boulevard Fleming, 25030, Besançon Cedex, France

    Charlotte Pourcelot, Camille Dirand, Garance Barbier, Sarah Chouk, Samuel Limat & Virginie Nerich

  2. Department of Medical Oncology, Besançon University Hospital, Boulevard Fleming, 25030, Besançon Cedex, France

    Emeline Orillard, Philippe Montcuquet & Loïc Chaigneau

  3. Federative Regional Institute for Cancer of Franche-Comté, Boulevard Fleming, 25030, Besançon Cedex, France

    Gilles Nallet

  4. ONCOLIE Network of Cancer, Boulevard Fleming, 25030, Besançon Cedex, France

    Gilles Nallet

  5. Department of Pharmacy, Lons-le-Saunier Hospital, Rue du Dr Jean Michel, 39000, Lons Le Saunier, France

    François Billion-Rey

  6. University of Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, Interactions hôte-greffon-tumeur – Ingénierie Cellulaire et Génique, Boulevard Fleming, 25020, Besançon Cedex, France

    Samuel Limat, Julie Henriques, Sophie Paget-Bailly, Amélie Anota & Virginie Nerich

  7. Besançon University Hospital, Methodological and Quality of Life in Cancerology Unit, University of Bourgogne Franche-Comté, Boulevard Fleming, 25000, Besançon, France

    Julie Henriques, Sophie Paget-Bailly & Amélie Anota

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  1. Charlotte Pourcelot
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  2. Emeline Orillard
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  3. Gilles Nallet
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Correspondence to Virginie Nerich.

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Pourcelot, C., Orillard, E., Nallet, G. et al. Adjuvant hormonal therapy for early breast cancer: an epidemiologic study of medication adherence. Breast Cancer Res Treat 169, 153–162 (2018). https://doi.org/10.1007/s10549-018-4676-3

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  • DOI: https://doi.org/10.1007/s10549-018-4676-3

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