Adherence to intravenous chemotherapy in African American and white women with early-stage breast cancer.
BACKGROUND
Adherence to intravenous chemotherapy offers survival and recurrence-free benefits for women diagnosed with early-stage breast cancer. However, previous studies have found that African American women are more likely to discontinue intravenous chemotherapy early, thus shortening their survival. Yet the existence of racial differences and predictors of adherence to chemotherapy treatment between African American and white women are largely understudied or inconsistent.


OBJECTIVE
The purposes of this study were to examine factors that influence the decision to adhere to chemotherapy in African American and white women diagnosed with early-stage breast cancer and to test for racial differences that may exist in this sample.


METHODS
The study recruited a convenience sample of 99 African American and white women. Factors examined were sociodemographic variables (age, race, access to healthcare), social support, religious coping, chemotherapy adverse effects, depression, breast cancer knowledge, health beliefs, cancer fatalism, and days from diagnosis to treatment. Data analyses included logistic regression modeling.


RESULTS
No racial differences in adherence to intravenous chemotherapy between African American and white women were found (χ = 2.627, P = .10). Days to treatment (odds ratio [OR], 0.982, P = .058), health insurance (OR, 0.121; P = .016), change in depression (OR, 0.935; P = .118), and symptom severity (OR, 0.950; P = .038) were independently associated with nonadherence to chemotherapy.


CONCLUSIONS
This study provides emerging evidence of factors that may be potentially modified with interventions at the clinical setting.


CONCLUSIONS
The findings can be used to spearhead future intervention studies that improve treatment decision making to chemotherapy adherence.
Author Affiliations: Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia (Drs Wells, Dalton, and Freeman); and Nicole Wertheim College of Nursing and Health Sciences, Florida International University, Miami (Dr Strickland).
Jessica S
JS
Wells
Ora L
OL
Strickland
Jo Ann
JA
Dalton
Sarah
S
Freeman
D061605:Administration, Intravenous / Q000451:nursing* / Q000706:statistics & numerical data; D000328:Adult; D001741:Black or African American / Q000523:psychology; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000009:adverse effects*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000523:psychology; D003866:Depressive Disorder / Q000150:complications; D005260:Female; D006801:Humans; D008875:Middle Aged; D010349:Patient Compliance / Q000706:statistics & numerical data*; D012944:Social Support; D044465:White People / Q000523:psychology
D000970:Antineoplastic Agents