medigraphic.com

2019, Number 6

<< Back Next >>

Rev Med Inst Mex Seguro Soc 2019; 57 (6)

Adherence to adjuvant hormonal therapy in patients with breast cancer

Camejo-Martínez N, Castillo-Leska C, Artagaveytia-Cóppola NA, Hernández-Ibero AL, Amarillo-Hernández DL, Apud-Yumati PS, Melo-Ramundo F, Delgado-Pebe LB

Language: Spanish
References: 25
Page: 357-363
PDF size: 144.88 Kb.


ABSTRACT

Background: Adherence to hormonal therapy (HT) treatment is a complex and multifaceted issue that can determine variations in response to treatment. However, it is little known about it in routine clinical practice.
Objective: To assess adherence to HT from 1 to 5 years of 190 patients treated at the Hospital de Clínicas (in Montevideo, Uruguay), and to identify factors for the interruption of therapy.
Material and methods: 190 patients treated with HT due to S I-III breast cancer were included from 2002 to 2012. The Kaplan-Meier method was used to assess the proportion of patients who discontinued HT, and the univariate analysis with log-rank test was used to identify factors leading to its interruption.
Results: Out of 190 patients enrolled in the study, 95.3, 87.9, 80.6, 76.4, and 69.5% were still complying with their HT by the first, second, third, fourth and fifth year, respectively. Therapy continuity was greater in patients who received HT combined with tamoxifen and aromatase inhibitors vs. those who received a single drug (p = 0.017).
Conclusion: This real-life evaluation showed that HT adherence was reduced by 30.5% at 5 years, despite that there is a well-known benefit of this treatment on overall survival (OS), that it is well-tolerated, and provided for free. In view of the significant impact that HT interruption may have on OS, further investigation is required to determine what cause patients to discontinue their HT, in order to guide our efforts and enable us to increase and optimize adherence.


REFERENCES

  1. Early Breast Cancer Trialists’ Collaborative Group (EBCTCG). Aromatase inhibitors versus tamoxifen in early breast cancer: patient-level meta-analysis of the randomized trials. Lancet. 2015;386(10001):1341-52.

  2. Greenberg RN. Overview of patient compliance with medication dosing: A literature review. Clin Ther. 1984; 6(5):592-9.

  3. Partridge AH, Wang PS, Winer EP, Avorn J. Non adherence to adjuvant tamoxifen therapy in women with primary breast cancer. J Clin Oncol. 2003;21(4):602-6.

  4. Barron TI, Connolly R, Bennett K, Feely J, Kennedy MJ. Early discontinuation of tamoxifen: a lesson for oncologists. Cancer. 2007;109(5):832-9.

  5. McCowan C, Shearer J, Donnan PT, Dewar JA, Crilly M, Thompson AM, et al. Cohort study examining tamoxifen adherence and its relationship to mortality in women with breast cancer. Br J Cancer. 2008;99(11): 1763-8.

  6. Owusu C, Buist DS, Field TS, Lash TL, Thwin SS, Geiger AM, et al. Predictors of tamoxifen discontinuation among older women with estrogen receptor-positive breast cancer. J Clin Oncol. 2008;26:549-55.

  7. Partridge AH, LaFountain A, Mayer E, Taylor BS, Winer E, Asnis-Alibozek A. Adherence to initial adjuvant anastrozole therapy among women with early-stage breast cancer. J Clin Oncol. 2008;26(4):556-62.

  8. Kimmick G, Anderson R, Camacho F, Bhosle M, Hwang W, Balkrishnan R. Adjuvant hormonal therapy use among insured, low-income women with breast cancer. J Clin Oncol. 2009;27(21):3445-51.

  9. Hershman DL, Kushi LH, Shao T, Buono D, Kershenbaum A, Tsai WY, et al. Early discontinuation and nonadherence to adjuvant hormonal therapy in a cohort of 8,769 early-stage breast cancer patients. J Clin Oncol. 2010;28(27):4120-8.

  10. Sedjo RL, Devine S. Predictors of non-adherence to aromatase inhibitors among commercially insured women with breast cancer. Breast Cancer Res Treat. 2011;125(1):191-200.

  11. Murphy CC, Bartholomew LK, Carpentier MY, Bluethmann SM, Vernon SW. Adherence to adjuvant hormonal therapy among breast cancer survivors in clinical practice: a systematic review. Breast Cancer Res Treat. 2012;134(2):459-78.

  12. Makubate B, Donnan PT, Dewar JA, Thompson AM, McGowan C. Cohort study of adherence to adjuvant endocrine therapy, breast cancer recurrence and mortality. Br J Cancer. 2013;108(7):1515-24.

  13. Friese C, Pini T, Li Y, Abrahame P, Graff J, Hamilton A, et al. Adjuvant endocrine therapy initiation and persistence in a diverse sample of patients with breast cancer. Breast Cancer Res Treat. 2013;138(3):931-9.

  14. Kimmick G, Edmond S, Bosworth H, Peppercorn J, Marcom P, Blackwell K, et al. Medication taking behaviors among breast cancer patients on adjuvant endocrine therapy. Breast. 2015;24(5):630-4.

  15. Sabaté E. Adherence to long-term therapies: Evidence for action. Basel, Switzerland: World Health Organization; 2003.

  16. Simpson SH, Eurich DT, MajumK SR, Padwal RS, Tsuyuki RT, Varney J, et al. A meta-analysis of the association between adherence to drug therapy and mortality. BMJ. 2006;333(7557):15.

  17. Kothawala P, Badamgarav E, Ryu S, Miller RM, Halbert RJ. Systematic review and meta-analysis of real-world adherence to drug therapy for osteoporosis. Mayo Clin Proc. 2007;82(12):1493-501.

  18. Darkow T, Henk HJ, Thomas SK, Feng W, Baladi JF, Goldberg GA, et al. Treatment interruptions and nonadherence with imatinib and associated healthcare costs: a retrospective analysis among managed care patients with chronic myelogenous leukaemia. PharmacoEconomics. 2007;25(6):481-96.

  19. Early Breast Cancer Trialists' Collaborative Group (EBCTCG). Effects of chemotherapy and hormonal therapy for early breast cancer on recurrence and 15 year survival: an overview of the randomised trials. Lancet. 2005;365 (9472):1687-717.

  20. Dowsett M, Cuzick J, Ingle J, Coates A, Forbes J, Bliss J, et al. Meta-analysis of breast cancer outcomes in adjuvant trials of aromatase inhibitors versus tamoxifen. J Clin Oncol. 2010;28(3):509-18.

  21. Dezentje VO, van Blijderveen NJ, Gelderblom H, Putter H, van Herk-Sukel MP, Casparie MK, et al. Effect of concomitant CYP2D6 inhibitor use and tamoxifen adherence on breast cancer recurrence in early-stage breast cancer. J Clin Oncol. 2010;28(14):2423-9.

  22. Nekhlyudov L, Li L, Ross-Degnan D, Wagner AK . Fiveyear patterns of adjuvant hormonal therapy use, persistence, and adherence among insured women with early-stage breast cancer. Breast Cancer Res Treat. 2011;130(2):681-9.

  23. Wigertz A, Ahlgren J, Holmqvist M, Fornander T, Adolfsson J, Lindman H, et al. Adherence and discontinuation of adjuvant hormonal therapy in breast cancer patients: a population-based study. Breast Cancer Res Treat. 2012; 133(1):367-73.

  24. Robinson B, Dijkstra B, Davey V, Tomlinson S, Frampton C. Adherence to Adjuvant Endocrine Therapy in Christchurch Women with Early Breast Cancer. Clin Oncol. 2018;30(1):e9-15.

  25. Haynes RB, McDonald H, Garg AX, Montague P. Interventions for helping patients to follow prescriptions for medications. Cochrane Database Syst Rev. 2002(2): CD000011.




2020     |     www.medigraphic.com