Adherence evaluation of endocrine treatment in breast cancer: methodological aspects
- PMID: 23066928
- PMCID: PMC3519669
- DOI: 10.1186/1471-2407-12-474
Adherence evaluation of endocrine treatment in breast cancer: methodological aspects
Abstract
Background: Current studies on adherence to endocrine therapy in breast cancer patients suffer from methodological limitations due to a lack of well-validated methods for assessing adherence. There is no gold standard for measuring adherence. The aim of our study was to compare four different approaches for evaluating adherence to anastrozole therapy for breast cancer with regard to concordance between methods.
Methods: Outpatients with early breast cancer treated with anastrozole completed the multi-method assessment of adherence. We implemented a self-report scale (the Simplified Medication Adherence Questionnaire), physician- ratings, refill records and determination of anastrozole serum concentration.
Results: Comparison of the four approaches using Spearman rank correlation revealed poor concordance across all methods reflecting weak correlations of 0.2-0.4. Considering this data incomparability across methods, we still observed high adherence rates of 78%-98% across measures.
Conclusion: Our findings contribute to the growing body of knowledge on the impact that methodological aspects exert on the results of adherence measurement in breast cancer patients receiving endocrine treatment. Our findings suggest that the development and validation of instruments specific to patients receiving endocrine agents is imperative in order to arrive at a more accurate assessment and to subsequently obtain more precise estimates of adherence rates in this patient population.
Figures
References
-
- Cuzick J, Sestak I, Baum M, Buzdar A, Howell A, Dowsett M, Forbes JF. investigators AL. Effect of anastrozole and tamoxifen as adjuvant treatment for early-stage breast cancer: 10-year analysis of the ATAC trial. Lancet Oncol. 2010;11(12):1135–1141. doi: 10.1016/S1470-2045(10)70257-6. - DOI - PubMed
-
- Urquhart J. In: Compliance in Healthcare and Research. edn. Ockene LBI, editor. Futura Publishing Company, New York; 2001. Biological measures; pp. 105–117.
-
- Waterhouse DM, Calzone KA, Mele C, Brenner DE. Adherence to oral tamoxifen: a comparison of patient self-report, pill counts, and microelectronic monitoring. J Clin Oncol. 1993;11(6):1189–1197. - PubMed
-
- Chlebowski RT, Geller ML. Adherence to endocrine therapy for breast cancer. Oncology. 2006;71(1–2):1–9. - PubMed
-
- Hershman DL, Shao T, Kushi LH, Buono D, Tsai WY, Fehrenbacher L, Kwan M, Gomez SL, Neugut AI. Early discontinuation and non-adherence to adjuvant hormonal therapy are associated with increased mortality in women with breast cancer. Breast Cancer Res Treat. 2011;126(2):529–537. doi: 10.1007/s10549-010-1132-4. - DOI - PMC - PubMed
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Medical