Facilitating adherence to endocrine therapy in breast cancer: stability and predictive power of treatment expectations in a 2-year prospective study
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Facilitating adherence to endocrine therapy in breast cancer: stability and predictive power of treatment expectations in a 2-year prospective study. / Pan, Yiqi; Heisig, Sarah R; von Blanckenburg, Pia; Albert, Ute-Susann; Hadji, Peyman; Rief, Winfried; Nestoriuc, Yvonne.
In: BREAST CANCER RES TR, Vol. 168, No. 3, 04.2018, p. 667-677.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research
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TY - JOUR
T1 - Facilitating adherence to endocrine therapy in breast cancer: stability and predictive power of treatment expectations in a 2-year prospective study
AU - Pan, Yiqi
AU - Heisig, Sarah R
AU - von Blanckenburg, Pia
AU - Albert, Ute-Susann
AU - Hadji, Peyman
AU - Rief, Winfried
AU - Nestoriuc, Yvonne
PY - 2018/4
Y1 - 2018/4
N2 - PURPOSE: To identify modifiable factors predictive of long-term adherence to adjuvant endocrine therapy (AET).METHODS: As part of a 2-year cohort study in primary care (n = 116), we investigated whether initial treatment expectations predict adherence at 24 months after controlling for demographic, medical, and psychosocial variables. Treatment expectations were measured as necessity-concern beliefs, expected side-effect severity, and expected coping with side effects. Their stability over time and differences of trajectories between the adherent and nonadherent group were examined.RESULTS: Nonadherence at 24 months was 14.7% (n = 17). Side-effect severity at 3 months [OR 0.25, 95% CI (0.08, 0.81), p = 0.02] and necessity-concern beliefs [OR 2.03, 95% CI (1.11, 3.72), p = 0.02] were the sole predictors of adherence. Necessity-concern beliefs remained stable over 2 years, whereas expected side-effect severity (p = 0.01, η p2 = 0.07) and expected coping with side effects became less optimistic over time (p < 0.001, η p2 = 0.19), the latter particularly among nonadherers (p < 0.01, η p2 = 0.10).CONCLUSIONS: Patients' initial necessity-concern beliefs about the AET and early severity of side effects affect long-term adherence. Expecting poor management of side effects may also facilitate nonadherence. We suggest that discussing benefits, addressing concerns of AET, and providing side-effect coping strategies could constitute a feasible and promising option to improve adherence in clinical practice.
AB - PURPOSE: To identify modifiable factors predictive of long-term adherence to adjuvant endocrine therapy (AET).METHODS: As part of a 2-year cohort study in primary care (n = 116), we investigated whether initial treatment expectations predict adherence at 24 months after controlling for demographic, medical, and psychosocial variables. Treatment expectations were measured as necessity-concern beliefs, expected side-effect severity, and expected coping with side effects. Their stability over time and differences of trajectories between the adherent and nonadherent group were examined.RESULTS: Nonadherence at 24 months was 14.7% (n = 17). Side-effect severity at 3 months [OR 0.25, 95% CI (0.08, 0.81), p = 0.02] and necessity-concern beliefs [OR 2.03, 95% CI (1.11, 3.72), p = 0.02] were the sole predictors of adherence. Necessity-concern beliefs remained stable over 2 years, whereas expected side-effect severity (p = 0.01, η p2 = 0.07) and expected coping with side effects became less optimistic over time (p < 0.001, η p2 = 0.19), the latter particularly among nonadherers (p < 0.01, η p2 = 0.10).CONCLUSIONS: Patients' initial necessity-concern beliefs about the AET and early severity of side effects affect long-term adherence. Expecting poor management of side effects may also facilitate nonadherence. We suggest that discussing benefits, addressing concerns of AET, and providing side-effect coping strategies could constitute a feasible and promising option to improve adherence in clinical practice.
KW - Journal Article
U2 - 10.1007/s10549-017-4637-2
DO - 10.1007/s10549-017-4637-2
M3 - SCORING: Journal article
C2 - 29330625
VL - 168
SP - 667
EP - 677
JO - BREAST CANCER RES TR
JF - BREAST CANCER RES TR
SN - 0167-6806
IS - 3
ER -