Evidence map›Paper›PMID 24928595›Full record

ArticleBMJ open2014

A hard pill to swallow: a qualitative study of women's experiences of adjuvant endocrine therapy for breast cancer.

Alison Harrow, Ruth Dryden, Colin McCowan, Andrew Radley, Mark Parsons, Alastair M Thompson, Mary Wells

Open access · goldAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ open, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 45 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
45citing papers in PubMed, 3 pooled it
4.4field-weighted citation impact, top 5% of its field
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

45 citing papers in PubMed, 3 syntheses or guidelines pooled it, 83 citations in OpenAlex.

  1. Systematic review of the needs and health-related quality of life domains relevant to people surviving cancer in Europe.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2025
    Pooled it
  2. Self-care behaviors in patients with cancer treated with oral anticancer agents: a systematic review.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2022
    Pooled it
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  17. Hobson's choice or a horned dilemma: a grounded theory on adherence to adjuvant endocrine therapy verified with breast cancer survivors.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2022
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 6 institutions in 2 countries.

Alison HarrowSchool of Nursing and Midwifery, University of Dundee, Dundee, UK.
Ruth DrydenInstitute for Research and Innovation in Social Services, Glasgow, UK.
Colin McCowanRobertson Centre for Biostatistics, University of Glasgow Boyd Orr Building, Glasgow, UK.
Andrew RadleyNHS Tayside, Directorate of Public Health, Kings Cross Hospital, Dundee, UK.
Mark ParsonsNHS Tayside, Pharmacy Department, Ninewells Hospital, Dundee, UK.
Alastair M ThompsonDepartment of Surgical Oncology, MD Anderson Cancer Center, Holcombe Boulevard, Houston, Texas, USA.
Mary WellsNMAHP Research Unit, Scion House, University of Stirling, Stirling, UK.
NHS Tayside · GBInstitute for Research and Innovation in Social Services · GBThe University of Texas MD Anderson Cancer Center · USUniversity of Dundee · GBUniversity of Glasgow · GBUniversity of Stirling · GB

Funding

Chief Scientist Office NMAHP1
6 · The paper itself

Abstract

objectiveTo explore women's experiences of taking adjuvant endocrine therapy as a treatment for breast cancer and how their beliefs about the purpose of the medication, side effects experienced and interactions with health professionals might influence adherence.

designQualitative study using semistructured, one-to-one interviews.

setting2 hospitals from a single health board in Scotland.

participants30 women who had been prescribed tamoxifen or aromatase inhibitors (anastrozole or letrozole) and had been taking this medication for 1-5 years.

resultsWomen clearly wished to take their adjuvant endocrine therapy medication as prescribed, believing that it offered them protection against breast cancer recurrence. However, some women missed tablets and did not recognise that this could reduce the efficacy of the treatment. Women did not perceive that healthcare professionals were routinely or systematically monitoring their adherence. Side effects were common and impacted greatly on the women's quality of life but did not always cause women to stop taking their medication, or to seek advice about reducing the side effects they experienced. Few were offered the opportunity to discuss the impact of side effects or the potential options available.

conclusionsAlthough most women in this study took adjuvant endocrine therapy as prescribed, many endured a range of side effects, often without seeking help. Advice, support and monitoring for adherence are not routinely offered in conventional follow-up settings. Women deserve more opportunity to discuss the pros, cons and impact of long-term adjuvant endocrine therapy. New service models are needed to support adherence, enhance quality of life and ultimately improve survival. These should ideally be community based, in order to promote self-management in the longer term.

Indexed as

AgedAnastrozoleAntineoplastic Agents, HormonalAromatase InhibitorsAttitude to HealthBreast NeoplasmsChemotherapy, AdjuvantFemaleHumansLetrozoleMedication AdherenceMiddle AgedNitrilesQualitative ResearchQuality of LifeTamoxifenAnastrozoleAntineoplastic Agents, HormonalAromatase InhibitorsLetrozoleNitrilesTamoxifenTriazolesORAL MEDICINEQUALITATIVE RESEARCH

Identifiers

PMID24928595
PMCPMC4067895
OpenAlexW2106251515

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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.