Potentially Modifiable Factors Associated with Adherence to Adjuvant Endocrine Therapy among Breast Cancer Survivors: A Systematic Review
Adjuvant endocrine therapy (AET) reduces risk of breast cancer recurrence. However, suboptimal adherence and persistence to AET remain important clinical issues. Understanding factors associated with adherence may help inform efforts to improve use of AET as prescribed. The present systematic review...
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| Format: | Article |
| Language: | English |
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MDPI AG
2020-12-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/13/1/107 |
| _version_ | 1797542838794190848 |
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| author | Kirsti I. Toivonen Tamara M. Williamson Linda E. Carlson Lauren M. Walker Tavis S. Campbell |
| author_facet | Kirsti I. Toivonen Tamara M. Williamson Linda E. Carlson Lauren M. Walker Tavis S. Campbell |
| author_sort | Kirsti I. Toivonen |
| collection | DOAJ |
| description | Adjuvant endocrine therapy (AET) reduces risk of breast cancer recurrence. However, suboptimal adherence and persistence to AET remain important clinical issues. Understanding factors associated with adherence may help inform efforts to improve use of AET as prescribed. The present systematic review examined potentially modifiable factors associated with adherence to AET in accordance with PRISMA guidelines (PROSPERO registration ID: CRD42019124200). All studies were included, whether factors were significantly associated with adherence or results were null. This review also accounted for the frequency with which a potentially modifiable factor was examined and whether univariate or multivariate models were used. This review also examined whether methodological or sample characteristics were associated with the likelihood of a factor being associated with AET adherence. A total of 68 articles were included. Potentially modifiable factors were grouped into six categories: side effects, attitudes toward AET, psychological factors, healthcare provider-related factors, sociocultural factors, and general/quality of life factors. Side effects were less likely to be associated with adherence in studies with retrospective or cross-sectional than prospective designs. Self-efficacy (psychological factor) and positive decisional balance (attitude toward AET) were the only potentially modifiable factors examined ≥10 times and associated with adherence or persistence ≥75% of the time in both univariate and multivariate models. Self-efficacy and decisional balance (i.e., weight of pros vs. cons) were the potentially modifiable factors most consistently associated with adherence, and hence may be worth focusing on as targets for interventions to improve AET adherence among breast cancer survivors. |
| first_indexed | 2024-03-10T13:36:09Z |
| format | Article |
| id | doaj.art-c1cf0a8157f141d2b38d862dfa44b060 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-10T13:36:09Z |
| publishDate | 2020-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-c1cf0a8157f141d2b38d862dfa44b0602023-11-21T07:31:49ZengMDPI AGCancers2072-66942020-12-0113110710.3390/cancers13010107Potentially Modifiable Factors Associated with Adherence to Adjuvant Endocrine Therapy among Breast Cancer Survivors: A Systematic ReviewKirsti I. Toivonen0Tamara M. Williamson1Linda E. Carlson2Lauren M. Walker3Tavis S. Campbell4Department of Psychology, University of Calgary, Calgary, AB T2N 1N4, CanadaDepartment of Psychology, University of Calgary, Calgary, AB T2N 1N4, CanadaDepartment of Oncology, University of Calgary, Calgary, AB T2N 1N4, CanadaDepartment of Oncology, University of Calgary, Calgary, AB T2N 1N4, CanadaDepartment of Psychology, University of Calgary, Calgary, AB T2N 1N4, CanadaAdjuvant endocrine therapy (AET) reduces risk of breast cancer recurrence. However, suboptimal adherence and persistence to AET remain important clinical issues. Understanding factors associated with adherence may help inform efforts to improve use of AET as prescribed. The present systematic review examined potentially modifiable factors associated with adherence to AET in accordance with PRISMA guidelines (PROSPERO registration ID: CRD42019124200). All studies were included, whether factors were significantly associated with adherence or results were null. This review also accounted for the frequency with which a potentially modifiable factor was examined and whether univariate or multivariate models were used. This review also examined whether methodological or sample characteristics were associated with the likelihood of a factor being associated with AET adherence. A total of 68 articles were included. Potentially modifiable factors were grouped into six categories: side effects, attitudes toward AET, psychological factors, healthcare provider-related factors, sociocultural factors, and general/quality of life factors. Side effects were less likely to be associated with adherence in studies with retrospective or cross-sectional than prospective designs. Self-efficacy (psychological factor) and positive decisional balance (attitude toward AET) were the only potentially modifiable factors examined ≥10 times and associated with adherence or persistence ≥75% of the time in both univariate and multivariate models. Self-efficacy and decisional balance (i.e., weight of pros vs. cons) were the potentially modifiable factors most consistently associated with adherence, and hence may be worth focusing on as targets for interventions to improve AET adherence among breast cancer survivors.https://www.mdpi.com/2072-6694/13/1/107reviewadherencebreast canceradjuvant endocrine therapy |
| spellingShingle | Kirsti I. Toivonen Tamara M. Williamson Linda E. Carlson Lauren M. Walker Tavis S. Campbell Potentially Modifiable Factors Associated with Adherence to Adjuvant Endocrine Therapy among Breast Cancer Survivors: A Systematic Review Cancers review adherence breast cancer adjuvant endocrine therapy |
| title | Potentially Modifiable Factors Associated with Adherence to Adjuvant Endocrine Therapy among Breast Cancer Survivors: A Systematic Review |
| title_full | Potentially Modifiable Factors Associated with Adherence to Adjuvant Endocrine Therapy among Breast Cancer Survivors: A Systematic Review |
| title_fullStr | Potentially Modifiable Factors Associated with Adherence to Adjuvant Endocrine Therapy among Breast Cancer Survivors: A Systematic Review |
| title_full_unstemmed | Potentially Modifiable Factors Associated with Adherence to Adjuvant Endocrine Therapy among Breast Cancer Survivors: A Systematic Review |
| title_short | Potentially Modifiable Factors Associated with Adherence to Adjuvant Endocrine Therapy among Breast Cancer Survivors: A Systematic Review |
| title_sort | potentially modifiable factors associated with adherence to adjuvant endocrine therapy among breast cancer survivors a systematic review |
| topic | review adherence breast cancer adjuvant endocrine therapy |
| url | https://www.mdpi.com/2072-6694/13/1/107 |
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