title: Barriers and facilitators to endocrine therapy adherence among underserved hormone-receptor-positive breast cancer survivors: a qualitative study.
abstract: To evaluate the barriers and facilitators to taking anti-hormonal medications among medically and historically underserved breast cancer survivors within the first 5 years post chemotherapy, radiation, and/or surgery.
  
  
  
  The current study was framed within the National Institutes of Health Centers for Population Health and Health Disparities Model (NIHCPHHD Model). Twenty-five historically or medically underserved breast cancer survivors participated in an in-depth interview, in either English or Spanish. Interviews were audio recorded and transcribed verbatim. Interview data were analyzed using content analysis.
  
  
  
  Anti-hormonal medication adherence was facilitated in several ways, including establishing a routine of medication taking, leaving the medicine in a visible or easily accessible place, taking the medication with other medications, reducing the cost of medicine, using a pillbox, understanding the negative consequences of lack of adherence, and having positive interactions with physicians. Side effects were the most commonly mentioned barrier to medication adherence.
  
  
  
  Similar to other research, this qualitative study of medically and historically underserved breast cancer survivors in the USA found that side effects are the most frequently endorsed barrier to anti-hormonal medication adherence. Conversely, there were a number of facilitators of correct and consistent anti-hormonal medication use. The management of side effects is critically important to increase adherence to anti-hormonal medications. Health care providers, support providers, and caregivers can encourage breast cancer survivors to better adhere to anti-hormonal medications using a number of approaches that have been successful for other women.
authors.affiliation: Department of Psychology, San Diego State University, 6363 Alvarado Court, Suite 103, San Diego, CA, 92120-4913, USA. kwells@mail.sdsu.edu.|University of California, San Diego Moores Cancer Center, La Jolla, CA, USA. kwells@mail.sdsu.edu.|SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA. kwells@mail.sdsu.edu.
authors.forename: Kristen J
authors.initials: KJ
authors.lastname: Wells
authors.affiliation: University of California, San Diego Moores Cancer Center, La Jolla, CA, USA.|SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA.
authors.forename: Tonya M
authors.initials: TM
authors.lastname: Pan
authors.affiliation: University of South Florida, Tampa, FL, USA.
authors.forename: Coralia
authors.initials: C
authors.lastname: Vázquez-Otero
authors.affiliation: University of South Florida, Tampa, FL, USA.
authors.forename: Danielle
authors.initials: D
authors.lastname: Ung
authors.affiliation: University of California, San Diego Moores Cancer Center, La Jolla, CA, USA.|SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA.
authors.forename: Amy E
authors.initials: AE
authors.lastname: Ustjanauskas
authors.affiliation: , San Diego State University Research Foundation, San Diego, CA, USA.
authors.forename: Dariana
authors.initials: D
authors.lastname: Muñoz
authors.affiliation: University of South Florida, Tampa, FL, USA.|Moffitt Cancer Center, Tampa, FL, USA.
authors.forename: Christine
authors.initials: C
authors.lastname: Laronga
authors.affiliation: University of South Florida, Tampa, FL, USA.|Moffitt Cancer Center, Tampa, FL, USA.
authors.forename: Richard G
authors.initials: RG
authors.lastname: Roetzheim
authors.affiliation: Department of Psychology, San Diego State University, 6363 Alvarado Court, Suite 103, San Diego, CA, 92120-4913, USA.
authors.forename: Marissa
authors.initials: M
authors.lastname: Goldenstein
authors.affiliation: , San Diego State University Research Foundation, San Diego, CA, USA.
authors.forename: Claudia
authors.initials: C
authors.lastname: Carrizosa
authors.affiliation: Emory University, Atlanta, GA, USA.
authors.forename: Sumayah
authors.initials: S
authors.lastname: Nuhaily
authors.affiliation: , South County Oncology and Hematology, Chula Vista, CA, USA.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Johnson
authors.affiliation: , South County Oncology and Hematology, Chula Vista, CA, USA.
authors.forename: Marilyn
authors.initials: M
authors.lastname: Norton
authors.affiliation: Sharp HealthCare, San Diego, CA, USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Sims
authors.affiliation: University of South Florida, Tampa, FL, USA.|Moffitt Cancer Center, Tampa, FL, USA.
authors.forename: Gwendolyn P
authors.initials: GP
authors.lastname: Quinn
mesh_terms: D000368:Aged; D018931:Antineoplastic Agents, Hormonal / Q000494:pharmacology / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D036301:Qualitative Research; D017741:Survivors; D016903:Drug Monitoring
chemical_list: D018931:Antineoplastic Agents, Hormonal
keywords: Breast cancer; Breast neoplasms; Cancer; Medication adherence; Oncology