Adherence to tamoxifen over the five-year course

Area of Science:

• Oncology
• Geriatric Medicine
• Pharmacology

Background:

• Adherence to adjuvant endocrine therapy is crucial for breast cancer treatment outcomes.
• Tamoxifen is a standard therapy for hormone receptor-positive breast cancer.
• Older women may face unique challenges in adhering to long-term medication regimens.

Purpose of the Study:

• To determine the rate of 5-year tamoxifen completion in older women with breast cancer.
• To identify factors associated with non-adherence to tamoxifen therapy in this population.

Main Methods:

• A cohort of 462 women aged 65 and older with Stage I-IIIA breast cancer initiated tamoxifen therapy.
• Annual patient interviews assessed adherence, while medical records and physician questionnaires gathered predictor data.
• Predictors included side effects, baseline and new prescription medications, and patient views on tamoxifen.

Main Results:

• Thirty-one percent of patients discontinued tamoxifen before completing the recommended 5-year course.
• Increased likelihood of discontinuation was associated with initial or developing severe side effects and adding new prescriptions.
• Higher adherence was linked to having more baseline prescriptions, positive baseline views of tamoxifen, and improving views over time.

Conclusions:

• Physicians should proactively discuss potential side effects, concurrent medications, and patient beliefs regarding tamoxifen.
• Educating patients on the long-term benefits of completing adjuvant tamoxifen therapy is essential.
• Addressing patient concerns and managing side effects may improve adherence and optimize breast cancer treatment outcomes.