title: Discontinuation and non-adherence to endocrine therapy in breast cancer patients: is lack of communication the decisive factor?
abstract: BACKGROUND
  Non-adherence to anti-hormonal therapy is a major problem in gynecologic oncology. Reasons reported are side effects and lack of support. The aim of our study was an analysis of influence of experiences of patients with endocrine therapy and communication and information on this topic and their influence on adherence.
  
  
  METHODS
  We developed a structured questionnaire which was tested in a pilot version and then programmed as online questionnaire and presented to patient members of self-help and breast cancer organizations.
  
  
  RESULTS
  Patients only had received scarce information on endocrine therapy. Only 12.8% stated that their questions were answered in detail, 43.2% got no answers or only non-detailed answers. 76% had side effects limiting functions of daily life. 60% of physicians did not react on these side effects. There is a significant correlation between number and intensity of side effects and non-adherence or disruption of therapy (p = 0.029 and p < 0.01, respectively). Women who reported having received detailed answers to their questions also reported better adherence (p = 0.014).
  
  
  CONCLUSIONS
  In order to improve adherence, detailed information on side effects and answers in case of symptoms are most important. Physicians should not rely on presenting written information but should mainly engage in direct communication.
authors.affiliation: Working Group Integrative Oncology, Dr. Senckenberg Chronomedical Institute, J. W. Goethe University, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany.
authors.forename: P
authors.initials: P
authors.lastname: Wuensch
authors.forename: A
authors.initials: A
authors.lastname: Hahne
authors.forename: R
authors.initials: R
authors.lastname: Haidinger
authors.forename: K
authors.initials: K
authors.lastname: Meißler
authors.forename: B
authors.initials: B
authors.lastname: Tenter
authors.forename: C
authors.initials: C
authors.lastname: Stoll
authors.forename: B
authors.initials: B
authors.lastname: Senf
authors.forename: J
authors.initials: J
authors.lastname: Huebner
mesh_terms: D000328:Adult; D000368:Aged; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000523:psychology; D003142:Communication; D004703:Endocrine System / Q000187:drug effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D055118:Medication Adherence; D008875:Middle Aged; D009367:Neoplasm Staging; D010818:Practice Patterns, Physicians'; D011379:Prognosis; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D018931:Antineoplastic Agents, Hormonal
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