Adjuvant endocrine therapy for premenopausal women with breast cancer: Patient adherence and physician prescribing practices in Mexico
Background: In resource-constrained settings, data regarding breast cancer patients' adherence to endocrine therapy (ET) and physicians’ prescribing practices is limited. This study aims to decrease this knowledge gap in a real-world clinical practice. Methods: Premenopausal women with stage 0-...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2021-10-01
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| Series: | Breast |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S0960977621003854 |
| _version_ | 1818643989641822208 |
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| author | Cynthia Villarreal-Garza Fernanda Mesa-Chavez Ana S. Ferrigno Cynthia De la Garza-Ramos Alan Fonseca Karen Villanueva-Tamez Jose Y. Campos-Salgado Marlid Cruz-Ramos David O. Rodriguez-Gomez Sandy Ruiz-Cruz Paula Cabrera-Galeana |
| author_facet | Cynthia Villarreal-Garza Fernanda Mesa-Chavez Ana S. Ferrigno Cynthia De la Garza-Ramos Alan Fonseca Karen Villanueva-Tamez Jose Y. Campos-Salgado Marlid Cruz-Ramos David O. Rodriguez-Gomez Sandy Ruiz-Cruz Paula Cabrera-Galeana |
| author_sort | Cynthia Villarreal-Garza |
| collection | DOAJ |
| description | Background: In resource-constrained settings, data regarding breast cancer patients' adherence to endocrine therapy (ET) and physicians’ prescribing practices is limited. This study aims to decrease this knowledge gap in a real-world clinical practice. Methods: Premenopausal women with stage 0-III hormone-sensitive breast cancer and receiving adjuvant ET during the past 1–5 years were identified in three Mexican referral centers. Participants' self-reported ET compliance, clinicopathologic characteristics, ET-related knowledge and beliefs, experienced adverse effects, social support, and patient-physician relationships were evaluated. Physician ET prescribing practices were compared with the gold standard according to international and national guidelines to assess clinicians’ adherence to standard-of-care prescription. Results: In total, 95/132 (72%) and 35/132 (27%) participants reported complete and acceptable adherence, respectively. Incomplete adherence was mainly attributed to forgetfulness, adverse effects, and unwillingness to take ET. Being employed/studying (p = 0.042), worrying about long-term ET use (p = 0.031), and experiencing >7 ET-related symptoms (p = 0.018) were associated with incomplete adherence. Guideline-endorsed regimens were prescribed in 84/132 (64%) patients, while the rest should have undergone ovarian function suppression (OFS) but instead received tamoxifen monotherapy. Conclusions: Premenopausal Mexican women self-report remarkably high rates of adequate ET adherence. However, a considerable proportion misses ≥1 doses/month, usually because of forgetfulness. Notably, only 64% receive standard-of-care ET due to suboptimal prescription of OFS. Interventions that remind patients to take their ET, refine physicians’ knowledge on the importance of OFS in high-risk patients, and increase access to OFS could prove pivotal to enhance optimal ET implementation and adherence, which could translate into improved patient outcomes. |
| first_indexed | 2024-12-17T00:07:43Z |
| format | Article |
| id | doaj.art-1ef59759239840abbfdd4dca315c75d4 |
| institution | Directory Open Access Journal |
| issn | 1532-3080 |
| language | English |
| last_indexed | 2024-12-17T00:07:43Z |
| publishDate | 2021-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Breast |
| spelling | doaj.art-1ef59759239840abbfdd4dca315c75d42022-12-21T22:10:55ZengElsevierBreast1532-30802021-10-0159815Adjuvant endocrine therapy for premenopausal women with breast cancer: Patient adherence and physician prescribing practices in MexicoCynthia Villarreal-Garza0Fernanda Mesa-Chavez1Ana S. Ferrigno2Cynthia De la Garza-Ramos3Alan Fonseca4Karen Villanueva-Tamez5Jose Y. Campos-Salgado6Marlid Cruz-Ramos7David O. Rodriguez-Gomez8Sandy Ruiz-Cruz9Paula Cabrera-Galeana10Breast Cancer Center, Hospital Zambrano Hellion TecSalud, Tecnologico de Monterrey, Batallon de San Patricio 112, San Pedro Garza Garcia, Nuevo Leon, 66278, Mexico; Joven & Fuerte: Programa para la Atencion e Investigacion de Mujeres Jovenes con Cancer de Mama en Mexico, Holbein 227, Int 210AB, Cd. de los Deportes, Mexico City, 03720, Mexico; Corresponding author. Breast Cancer Center, Hospital Zambrano Hellion TecSalud, Tecnologico de Monterrey, Batallon de San Patricio 112, 14th Floor, Real de San Agustin, San Pedro Garza Garcia, Nuevo Leon, 66278, Mexico.Breast Cancer Center, Hospital Zambrano Hellion TecSalud, Tecnologico de Monterrey, Batallon de San Patricio 112, San Pedro Garza Garcia, Nuevo Leon, 66278, Mexico; Joven & Fuerte: Programa para la Atencion e Investigacion de Mujeres Jovenes con Cancer de Mama en Mexico, Holbein 227, Int 210AB, Cd. de los Deportes, Mexico City, 03720, MexicoBreast Cancer Center, Hospital Zambrano Hellion TecSalud, Tecnologico de Monterrey, Batallon de San Patricio 112, San Pedro Garza Garcia, Nuevo Leon, 66278, Mexico; Joven & Fuerte: Programa para la Atencion e Investigacion de Mujeres Jovenes con Cancer de Mama en Mexico, Holbein 227, Int 210AB, Cd. de los Deportes, Mexico City, 03720, MexicoBreast Cancer Center, Hospital Zambrano Hellion TecSalud, Tecnologico de Monterrey, Batallon de San Patricio 112, San Pedro Garza Garcia, Nuevo Leon, 66278, Mexico; Joven & Fuerte: Programa para la Atencion e Investigacion de Mujeres Jovenes con Cancer de Mama en Mexico, Holbein 227, Int 210AB, Cd. de los Deportes, Mexico City, 03720, MexicoJoven & Fuerte: Programa para la Atencion e Investigacion de Mujeres Jovenes con Cancer de Mama en Mexico, Holbein 227, Int 210AB, Cd. de los Deportes, Mexico City, 03720, Mexico; Departamento de Tumores Mamarios e Investigacion, Instituto Nacional de Cancerologia, San Fernando 22, Belisario Dominguez Secc 16, Tlalpan, Mexico City, 14080, MexicoBreast Cancer Center, Hospital Zambrano Hellion TecSalud, Tecnologico de Monterrey, Batallon de San Patricio 112, San Pedro Garza Garcia, Nuevo Leon, 66278, MexicoDepartamento de Tumores Mamarios e Investigacion, Instituto Nacional de Cancerologia, San Fernando 22, Belisario Dominguez Secc 16, Tlalpan, Mexico City, 14080, MexicoJoven & Fuerte: Programa para la Atencion e Investigacion de Mujeres Jovenes con Cancer de Mama en Mexico, Holbein 227, Int 210AB, Cd. de los Deportes, Mexico City, 03720, Mexico; Departamento de Tumores Mamarios e Investigacion, Instituto Nacional de Cancerologia, San Fernando 22, Belisario Dominguez Secc 16, Tlalpan, Mexico City, 14080, MexicoBreast Cancer Center, Hospital Zambrano Hellion TecSalud, Tecnologico de Monterrey, Batallon de San Patricio 112, San Pedro Garza Garcia, Nuevo Leon, 66278, MexicoDepartamento de Tumores Mamarios e Investigacion, Instituto Nacional de Cancerologia, San Fernando 22, Belisario Dominguez Secc 16, Tlalpan, Mexico City, 14080, MexicoDepartamento de Tumores Mamarios e Investigacion, Instituto Nacional de Cancerologia, San Fernando 22, Belisario Dominguez Secc 16, Tlalpan, Mexico City, 14080, MexicoBackground: In resource-constrained settings, data regarding breast cancer patients' adherence to endocrine therapy (ET) and physicians’ prescribing practices is limited. This study aims to decrease this knowledge gap in a real-world clinical practice. Methods: Premenopausal women with stage 0-III hormone-sensitive breast cancer and receiving adjuvant ET during the past 1–5 years were identified in three Mexican referral centers. Participants' self-reported ET compliance, clinicopathologic characteristics, ET-related knowledge and beliefs, experienced adverse effects, social support, and patient-physician relationships were evaluated. Physician ET prescribing practices were compared with the gold standard according to international and national guidelines to assess clinicians’ adherence to standard-of-care prescription. Results: In total, 95/132 (72%) and 35/132 (27%) participants reported complete and acceptable adherence, respectively. Incomplete adherence was mainly attributed to forgetfulness, adverse effects, and unwillingness to take ET. Being employed/studying (p = 0.042), worrying about long-term ET use (p = 0.031), and experiencing >7 ET-related symptoms (p = 0.018) were associated with incomplete adherence. Guideline-endorsed regimens were prescribed in 84/132 (64%) patients, while the rest should have undergone ovarian function suppression (OFS) but instead received tamoxifen monotherapy. Conclusions: Premenopausal Mexican women self-report remarkably high rates of adequate ET adherence. However, a considerable proportion misses ≥1 doses/month, usually because of forgetfulness. Notably, only 64% receive standard-of-care ET due to suboptimal prescription of OFS. Interventions that remind patients to take their ET, refine physicians’ knowledge on the importance of OFS in high-risk patients, and increase access to OFS could prove pivotal to enhance optimal ET implementation and adherence, which could translate into improved patient outcomes.http://www.sciencedirect.com/science/article/pii/S0960977621003854Breast cancerEndocrine therapyAdherencePremenopausalPrescribing practicesMexico |
| spellingShingle | Cynthia Villarreal-Garza Fernanda Mesa-Chavez Ana S. Ferrigno Cynthia De la Garza-Ramos Alan Fonseca Karen Villanueva-Tamez Jose Y. Campos-Salgado Marlid Cruz-Ramos David O. Rodriguez-Gomez Sandy Ruiz-Cruz Paula Cabrera-Galeana Adjuvant endocrine therapy for premenopausal women with breast cancer: Patient adherence and physician prescribing practices in Mexico Breast Breast cancer Endocrine therapy Adherence Premenopausal Prescribing practices Mexico |
| title | Adjuvant endocrine therapy for premenopausal women with breast cancer: Patient adherence and physician prescribing practices in Mexico |
| title_full | Adjuvant endocrine therapy for premenopausal women with breast cancer: Patient adherence and physician prescribing practices in Mexico |
| title_fullStr | Adjuvant endocrine therapy for premenopausal women with breast cancer: Patient adherence and physician prescribing practices in Mexico |
| title_full_unstemmed | Adjuvant endocrine therapy for premenopausal women with breast cancer: Patient adherence and physician prescribing practices in Mexico |
| title_short | Adjuvant endocrine therapy for premenopausal women with breast cancer: Patient adherence and physician prescribing practices in Mexico |
| title_sort | adjuvant endocrine therapy for premenopausal women with breast cancer patient adherence and physician prescribing practices in mexico |
| topic | Breast cancer Endocrine therapy Adherence Premenopausal Prescribing practices Mexico |
| url | http://www.sciencedirect.com/science/article/pii/S0960977621003854 |
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