The impact of symptom clusters on endocrine therapy adherence in patients with breast cancer
Background: When taken as prescribed, endocrine therapy is effective in reducing risk of recurrence and mortality in the treatment of patients with breast cancer. However, treatment side effects can act as a barrier to medication adherence. Existing research has not identified any specific side effe...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2024-06-01
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| Series: | Breast |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0960977624000626 |
| _version_ | 1797214908215984128 |
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| author | Sommer Agnew Megan Crawford Iain MacPherson Victor Shiramizu Leanne Fleming |
| author_facet | Sommer Agnew Megan Crawford Iain MacPherson Victor Shiramizu Leanne Fleming |
| author_sort | Sommer Agnew |
| collection | DOAJ |
| description | Background: When taken as prescribed, endocrine therapy is effective in reducing risk of recurrence and mortality in the treatment of patients with breast cancer. However, treatment side effects can act as a barrier to medication adherence. Existing research has not identified any specific side effects as consistent predictors of nonadherence. Our aim was to explore the influence of symptom clusters on self-reported adherence in patients with breast cancer. Methods: A cross-sectional online survey was conducted, including patients with breast cancer currently or previously prescribed endocrine therapy (N = 1051). This included measures of self-reported endocrine therapy adherence and common symptoms among this population (insomnia, depression, anxiety, fatigue, musculoskeletal, and vasomotor symptoms). Results: Unintentional nonadherence was higher than intentional nonadherence (50.8 % vs 31.01 %). The most troublesome symptom was insomnia (73.83 % displayed probable insomnia disorder). K-means cluster analysis identified 2 symptom clusters: overall High symptoms, and overall Low symptoms. Participants in the Low symptoms cluster were significantly more likely to be classed as adherent based on unintentional and intentional items. Conclusions: Nonadherence was high in the current sample, and significantly more likely in participants reporting overall severe symptoms. Clinicians should be aware of the scale of common side effects and facilitate open conversation about potential barriers to adherence. Follow-up care should include assessment of common symptoms and signpost patients to appropriate support or treatment when required. Future research should explore potential for a central symptom to act as a target for intervention, to relieve overall side effect burden and facilitate better medication adherence. |
| first_indexed | 2024-04-24T11:21:39Z |
| format | Article |
| id | doaj.art-9aaedc105a75429f8e6b55f89171c16b |
| institution | Directory Open Access Journal |
| issn | 1532-3080 |
| language | English |
| last_indexed | 2024-04-24T11:21:39Z |
| publishDate | 2024-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Breast |
| spelling | doaj.art-9aaedc105a75429f8e6b55f89171c16b2024-04-11T04:40:51ZengElsevierBreast1532-30802024-06-0175103731The impact of symptom clusters on endocrine therapy adherence in patients with breast cancerSommer Agnew0Megan Crawford1Iain MacPherson2Victor Shiramizu3Leanne Fleming4University of Strathclyde, 16 Richmond St, Glasgow, G1 1XQ, Scotland, UK; Corresponding author.University of Strathclyde, 16 Richmond St, Glasgow, G1 1XQ, Scotland, UKUniversity of Glasgow, Glasgow, G12 8QQ, Scotland, UKUniversity of Strathclyde, 16 Richmond St, Glasgow, G1 1XQ, Scotland, UKUniversity of Strathclyde, 16 Richmond St, Glasgow, G1 1XQ, Scotland, UKBackground: When taken as prescribed, endocrine therapy is effective in reducing risk of recurrence and mortality in the treatment of patients with breast cancer. However, treatment side effects can act as a barrier to medication adherence. Existing research has not identified any specific side effects as consistent predictors of nonadherence. Our aim was to explore the influence of symptom clusters on self-reported adherence in patients with breast cancer. Methods: A cross-sectional online survey was conducted, including patients with breast cancer currently or previously prescribed endocrine therapy (N = 1051). This included measures of self-reported endocrine therapy adherence and common symptoms among this population (insomnia, depression, anxiety, fatigue, musculoskeletal, and vasomotor symptoms). Results: Unintentional nonadherence was higher than intentional nonadherence (50.8 % vs 31.01 %). The most troublesome symptom was insomnia (73.83 % displayed probable insomnia disorder). K-means cluster analysis identified 2 symptom clusters: overall High symptoms, and overall Low symptoms. Participants in the Low symptoms cluster were significantly more likely to be classed as adherent based on unintentional and intentional items. Conclusions: Nonadherence was high in the current sample, and significantly more likely in participants reporting overall severe symptoms. Clinicians should be aware of the scale of common side effects and facilitate open conversation about potential barriers to adherence. Follow-up care should include assessment of common symptoms and signpost patients to appropriate support or treatment when required. Future research should explore potential for a central symptom to act as a target for intervention, to relieve overall side effect burden and facilitate better medication adherence.http://www.sciencedirect.com/science/article/pii/S0960977624000626Breast cancerEndocrine therapyAdherenceSymptom clusters |
| spellingShingle | Sommer Agnew Megan Crawford Iain MacPherson Victor Shiramizu Leanne Fleming The impact of symptom clusters on endocrine therapy adherence in patients with breast cancer Breast Breast cancer Endocrine therapy Adherence Symptom clusters |
| title | The impact of symptom clusters on endocrine therapy adherence in patients with breast cancer |
| title_full | The impact of symptom clusters on endocrine therapy adherence in patients with breast cancer |
| title_fullStr | The impact of symptom clusters on endocrine therapy adherence in patients with breast cancer |
| title_full_unstemmed | The impact of symptom clusters on endocrine therapy adherence in patients with breast cancer |
| title_short | The impact of symptom clusters on endocrine therapy adherence in patients with breast cancer |
| title_sort | impact of symptom clusters on endocrine therapy adherence in patients with breast cancer |
| topic | Breast cancer Endocrine therapy Adherence Symptom clusters |
| url | http://www.sciencedirect.com/science/article/pii/S0960977624000626 |
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