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Factors associated with intentional and unintentional non-adherence to adjuvant endocrine therapy following breast cancer

Factors associated with intentional and unintentional non-adherence to adjuvant endocrine therapy following breast cancer
Factors associated with intentional and unintentional non-adherence to adjuvant endocrine therapy following breast cancer
Adherence to adjuvant endocrine therapy (AET) following breast cancer is known to be suboptimal despite its known efficacy in reducing recurrence and mortality. This study aims to investigate factors associated with non-adherence and inform the development of interventions to support women and promote adherence. A questionnaire survey to measure level of adherence, side effects experienced, beliefs about medicine, support received and socio-demographic details was sent to 292 women 2–4 years post breast cancer diagnosis. Differences between non-adherers and adherers to AET were explored, and factors associated with intentional and unintentional non-adherence are reported. Approximately one quarter of respondents, 46 (22%), were non-adherers, comprising 29 (14%) intentional non-adherers and 17 (8%) unintentional non-adherers. Factors significantly associated with intentional non-adherence were the presence of side effects (p < .03), greater concerns about AET (p < .001) and a lower perceived necessity to take AET (p < .001). Half of the sample (105/211) reported that side effects had a moderate or high impact on their quality of life. Factors associated with unintentional non-adherence were younger age (<65) (p < .001), post-secondary education (p = .046) and paid employment (p = .031). There are distinct differences between intentional non-adherence and unintentional non-adherence. Differentiation between the two types of non-adherence may help tailor support and advice interventions.
0961-5423
1-20
Brett, J.
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Fenlon, D.
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Boulton, M.
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Hulbert-Williams, N.
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Walker, F.
21965e9a-79d0-499b-ab1c-98fe73c3cd81
Donnelly, P.
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Lavery, B.
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Morgan, A.
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Morris, C.
387ec7b1-5f3f-45f2-8444-255524852be5
Watson, E.
b478d08d-9f24-4572-a223-a85c1f26bcf0
Brett, J.
27e6419b-b342-4da2-9c30-71cc396da3b6
Fenlon, D.
52f9a9f1-1643-449c-9856-258ef563342c
Boulton, M.
f929384c-a0d8-4611-8105-30f97e6c835e
Hulbert-Williams, N.
271619b2-d0ae-4988-85ad-59a91c61e973
Walker, F.
21965e9a-79d0-499b-ab1c-98fe73c3cd81
Donnelly, P.
a355b599-37af-46e9-81c4-7e394ec51b42
Lavery, B.
552be754-8cec-426f-b5f5-131661865b9d
Morgan, A.
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Morris, C.
387ec7b1-5f3f-45f2-8444-255524852be5
Watson, E.
b478d08d-9f24-4572-a223-a85c1f26bcf0

Brett, J., Fenlon, D., Boulton, M., Hulbert-Williams, N., Walker, F., Donnelly, P., Lavery, B., Morgan, A., Morris, C. and Watson, E. (2016) Factors associated with intentional and unintentional non-adherence to adjuvant endocrine therapy following breast cancer. European Journal of Cancer Care, 1-20. (doi:10.1111/ecc.12601). (PMID:27901302)

Record type: Article

Abstract

Adherence to adjuvant endocrine therapy (AET) following breast cancer is known to be suboptimal despite its known efficacy in reducing recurrence and mortality. This study aims to investigate factors associated with non-adherence and inform the development of interventions to support women and promote adherence. A questionnaire survey to measure level of adherence, side effects experienced, beliefs about medicine, support received and socio-demographic details was sent to 292 women 2–4 years post breast cancer diagnosis. Differences between non-adherers and adherers to AET were explored, and factors associated with intentional and unintentional non-adherence are reported. Approximately one quarter of respondents, 46 (22%), were non-adherers, comprising 29 (14%) intentional non-adherers and 17 (8%) unintentional non-adherers. Factors significantly associated with intentional non-adherence were the presence of side effects (p < .03), greater concerns about AET (p < .001) and a lower perceived necessity to take AET (p < .001). Half of the sample (105/211) reported that side effects had a moderate or high impact on their quality of life. Factors associated with unintentional non-adherence were younger age (<65) (p < .001), post-secondary education (p = .046) and paid employment (p = .031). There are distinct differences between intentional non-adherence and unintentional non-adherence. Differentiation between the two types of non-adherence may help tailor support and advice interventions.

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Accepted/In Press date: 14 September 2016
e-pub ahead of print date: 30 November 2016
Published date: 30 November 2016
Organisations: Faculty of Health Sciences

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Local EPrints ID: 401674
URI: https://eprints.soton.ac.uk/id/eprint/401674
ISSN: 0961-5423
PURE UUID: 64ddc600-889e-4b1b-afb3-b3aeba247cfb

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Date deposited: 19 Oct 2016 11:06
Last modified: 15 Aug 2019 05:16

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Contributors

Author: J. Brett
Author: D. Fenlon
Author: M. Boulton
Author: N. Hulbert-Williams
Author: F. Walker
Author: P. Donnelly
Author: B. Lavery
Author: A. Morgan
Author: C. Morris
Author: E. Watson

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