Evidence map›Paper›PMID 20585090›Full record

ArticleJournal of clinical oncology : official journal of the American Society of Clinical Oncology2010

Early discontinuation and nonadherence to adjuvant hormonal therapy in a cohort of 8,769 early-stage breast cancer patients.

Dawn L Hershman, Lawrence H Kushi, Theresa Shao, Donna Buono, Aaron Kershenbaum, Wei-Yann Tsai, Louis Fehrenbacher, Scarlett Lin Gomez, Sunita Miles, Alfred I Neugut

Abstract read
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In one paragraph

Article in Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 440 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
440citing papers in PubMed, 5 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

440 citing papers in PubMed, 5 syntheses or guidelines pooled it.

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  16. Optimization of an Information Leaflet to Influence Medication Beliefs in Women With Breast Cancer: A Randomized Factorial Experiment.Annals of behavioral medicine : a publication of the Society of Behavioral Medicine · 2023
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380 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors.

Dawn L HershmanMailman School of Public Health, Columbia University Medical Center, 161 Fort Washington Ave, New York, NY 10032, USA. dlh23@columbia.edu
Lawrence H Kushi
Theresa Shao
Donna Buono
Aaron Kershenbaum
Wei-Yann Tsai
Louis Fehrenbacher
Scarlett Lin Gomez
Sunita Miles
Alfred I Neugut

Funding

Prospective Study of Breast Cancer SurvivorshipR01CA105274 · NCI · KAISER FOUNDATION RESEARCH INSTITUTE · PI KUSHI, LAWRENCE H · 2004 to 2014
$19.9M
NCI NIH HHS BC043120NCI NIH HHS N01 PC035136NCI NIH HHS N01-PC-35136NCI NIH HHS R01 CA105274
6 · The paper itself

Abstract

purposeWhile studies have found that adjuvant hormonal therapy for hormone-sensitive breast cancer (BC) dramatically reduces recurrence and mortality, adherence to medications is suboptimal. We investigated the rates and predictors of early discontinuation and nonadherence to hormonal therapy in patients enrolled in Kaiser Permanente of Northern California health system. PATIENTS AND

methodsWe identified women diagnosed with hormone-sensitive stage I-III BC from 1996 to 2007 and used automated pharmacy records to identify hormonal therapy prescriptions and dates of refill. We used Cox proportional hazards regression models to analyze factors associated with early discontinuation and nonadherence (medication possession ratio < 80%) of hormonal therapy.

resultsWe identified 8,769 patients with BC who met our eligibility criteria and who filled at least one prescription for tamoxifen (43%), aromatase inhibitors (26%), or both (30%) within 1 year of diagnosis. Younger or older age, lumpectomy (v mastectomy), and comorbidities were associated with earlier discontinuation, while Asian race, being married, earlier year at diagnosis, receipt of chemotherapy or radiotherapy, and longer prescription refill interval were associated with completion of 4.5 years of therapy. Of those who continued therapy, similar factors were associated with full adherence. Women age younger than 40 years had the highest risk of discontinuation (hazard ratio, 1.51; 95% CI, 1.23 to 1.85). By 4.5 years, 32% discontinued therapy, and of those who continued, 72% were fully adherent.

conclusionOnly 49% of patients with BC took adjuvant hormonal therapy for the full duration at the optimal schedule. Younger women are at high risk of nonadherence. Interventions to improve adherence and continuation of hormonal therapy are needed, especially for younger women.

Indexed as

Medication AdherenceAgedAge FactorsAntineoplastic Agents, HormonalAromatase InhibitorsBreast NeoplasmsCaliforniaChemotherapy, AdjuvantCohort StudiesDrug PrescriptionsFemaleHealth Maintenance OrganizationsHumansInsurance, Pharmaceutical ServicesKaplan-Meier EstimateMiddle AgedAntineoplastic Agents, HormonalAromatase InhibitorsTamoxifen

Identifiers

PMID20585090
PMCPMC2953970

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.