title: The relationship between risk factors and medication adherence among breast cancer survivors: What explanatory role might depression play?
abstract: OBJECTIVE
  Despite the efficacy of clinical treatments (eg, adjuvant hormonal therapy) for breast cancer survivors (BCS), nonadherence rates remain high, increasing the risk of recurrence and mortality. The current study tested a theoretical model of medical nonadherence that proposes depression to be the most proximal predictor of medical nonadherence among BCS.
  
  
  METHODS
  Breast cancer survivors were recruited from radiation clinics in Missouri. Survey data were collected 12 months after the end of primary treatment. The sample size included 133 BCS.
  
  
  RESULTS
  Findings show substantial support for the model, demonstrating that depression mediated the relation between physical symptoms, cognitive symptoms, social support, and adherence to medication. This finding was replicated with a measure of mood disturbance.
  
  
  CONCLUSIONS
  These findings support the prediction that medication nonadherence among BCS multiply determined process and have compelling implications for healthcare providers and interventions designed to increase medication adherence among BCS.
authors.affiliation: University of Missouri, Columbia, MO, USA.
authors.forename: Louis C
authors.initials: LC
authors.lastname: Markovitz
authors.affiliation: University of Missouri, Columbia, MO, USA.
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Drysdale
authors.affiliation: University of Missouri, Columbia, MO, USA.
authors.forename: B Ann
authors.initials: BA
authors.lastname: Bettencourt
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000523:psychology*; D000073116:Cancer Survivors / Q000523:psychology*; D003131:Combined Modality Therapy; D003863:Depression / Q000523:psychology*; D003866:Depressive Disorder; D005260:Female; D006801:Humans; D055118:Medication Adherence / Q000523:psychology*; D008875:Middle Aged; D008923:Missouri; D008960:Models, Psychological; D008962:Models, Theoretical; D009364:Neoplasm Recurrence, Local; D012307:Risk Factors; D011795:Surveys and Questionnaires
keywords: cancer; depression; medication adherence; oncology; physical functioning