Modifiable risk factors for adherence to adjuvant endocrine therapy among breast cancer patients.

ABSTRACT

OBJECTIVE: Breast cancer incidence and mortality are declining due to improvements in early detection and treatment. One advance in treatment is the development of adjuvant endocrine therapy (AET) for women with hormone receptor positive breast cancer. Despite strong evidence linking AET to better health outcomes, AET adherence continues to be suboptimal. This study tests the hypothesis that patient beliefs about medication mediate the relationship between frequency of physician communication and AET adherence. METHODS: This cross-sectional study utilizes data from patient self-report and medical chart abstraction (N=200). Survey measures included frequency of physician communication, patient beliefs about medicine, AET adherence, and demographic characteristics. RESULTS: Necessity beliefs mediated the relationship between frequency of physician communication and medication adherence (necessity beliefs ß=.18, p<.05; physician communication ß=.13, p>.05). There was no evidence of medication concerns mediating the relationship between frequency of physician communication and medication adherence. CONCLUSION: More frequent physician communication that shapes what patients believe about AET importance may be associated with greater AET adherence; however, frequent physician communication that shapes patient concerns about side effects may not be associated with greater AET adherence. PRACTICE IMPLICATIONS Research is needed to enhance understanding of the type of physician communication that is most consistently associated with patient beliefs about medication and AET adherence.