Adherence to Oral Hormonal Treatment among Breast Cancer Patients in Egypt

Abstract

Background: Adjuvant endocrine therapy has been shown to improve treatment outcomes in breast cancer patients. However, not all patients can complete their scheduled treatment protocols. The purpose of this study was to evaluate the adherence to oral hormonal therapy among Egyptian breast cancer patients.

Patients and methods: A cross-sectional study was conducted at the National Cancer Institute, Breast Cancer Hospital, from February 2022 to May 2022. An interview and a survey were administered to assess the adherence of breast cancer patients to oral hormonal treatment. Adherence was measured using the Morisky Medication Adherence Scale-8 (MMAS-8).

Results: The survey was fully completed by 300 patients, of whom 98.3% were females and 1.7% were males. Among the patients, 30% fell into the age group of 40-50 years. Most patients were postmenopausal (90.3%). In terms of education, 18% had a high level of education, while 53.3% were illiterate. Additionally, 50.7% of patients had other chronic diseases. Regarding medication information, 44.7% preferred to receive it from a physician, 27.7% from pharmacists, and 27.7% from both. Proper medication counseling was received by 99.7% of patients. According to the MMAS-8 survey, 40.3% of all patients demonstrated high adherence to their oral hormonal treatment, 32.7% had moderate adherence, and 27% had low adherence. No significant associations were found between adherence levels and subgroups such as gender, age, educational level, duration of endocrine therapy, breast cancer stage, or other co-morbidities.

Conclusion: This study reveals a substantial level of adherence, both high and moderate, to oral endocrine therapy among breast cancer patients in Egypt. Possible contributing factors include proper medication counseling within the healthcare setting and regular patient follow-up.

Keywords: Keywords: Adherence; Tamoxifen; aromatase inhibitor; breast cancer.