Modifiable risk factors for adherence to adjuvant endocrine therapy among breast cancer patients.
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 β=.18, p<.05; physician communication β=.13, p>.05). There was no evidence of medication concerns mediating the relationship between frequency of physician communication and medication adherence.


CONCLUSIONS
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.


CONCLUSIONS
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.
Rollins School of Public Health of Emory University, Department of Behavioral Sciences and Health Education, Atlanta, USA. Electronic address: kjacoba@sph.emory.edu.
Kimberly R
KR
Jacob Arriola
Rollins School of Public Health of Emory University, Department of Behavioral Sciences and Health Education, Atlanta, USA.
Tamara A
TA
Mason
Rollins School of Public Health of Emory University, Department of Behavioral Sciences and Health Education, Atlanta, USA.
Kari Ann
KA
Bannon
Rollins School of Public Health of Emory University, Department of Behavioral Sciences and Health Education, Atlanta, USA.
Carol
C
Holmes
Rollins School of Public Health of Emory University, Department of Behavioral Sciences and Health Education, Atlanta, USA.
Cecil Lamonte
CL
Powell
Emory University School of Medicine and Winship Cancer Institute, Atlanta, USA.
Kandra
K
Horne
Emory University School of Medicine and Winship Cancer Institute, Atlanta, USA.
Ruth
R
O'Regan
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D001294:Attitude to Health; D001943:Breast Neoplasms / Q000188:drug therapy*; D017024:Chemotherapy, Adjuvant; D003142:Communication; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D055118:Medication Adherence; D008875:Middle Aged; D010817:Physician-Patient Relations; D012307:Risk Factors; D012959:Socioeconomic Factors
D018931:Antineoplastic Agents, Hormonal
Adherence; Adjuvant endocrine therapy; Breast cancer; Medication beliefs