ArticleOncology nursing forum2017
Deconstructing Decisions to Initiate, Maintain, or Discontinue Adjuvant Endocrine Therapy in Breast Cancer Survivors: A Mixed-Methods Study.
Article in Oncology nursing forum, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 2 of them syntheses that pooled it.
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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.
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Who cites it
30 citing papers in PubMed, 2 syntheses or guidelines pooled it, 52 citations in OpenAlex.
- Experiences of Cancer-Related Cognitive Impairment Across Cancer Types: Qualitative Systematic Review.JMIR cancer · 2025Pooled it
- The impact of medication side effects on adherence and persistence to hormone therapy in breast cancer survivors: A qualitative systematic review and thematic synthesis.Breast (Edinburgh, Scotland) · 2021Pooled it
- Trial
- Factors associated with initiation and continuation of endocrine therapy in women with hormone receptor-positive breast cancer.BMC cancer · 2022Trial
- Impact of Side Effects on 5-Year Adherence to Adjuvant Endocrine Therapy in Women with Breast Cancer: An Integrative Review.International journal of women's health · 2026Review
- Quality of life in women with early-stage and metastatic hormone receptor-positive, HER2-negative breast cancer receiving endocrine therapy.The oncologist · 2024Observational
- Sticking to the script: Breast cancer patients' decision making regarding oral endocrine therapy.Patient education and counseling · 2024Article
- Adherence to Oral Hormonal Treatment among Breast Cancer Patients in Egypt.Asian Pacific journal of cancer prevention : APJCP · 2024Article
- The Experience of Patients with Endocrine Therapy for Breast Cancer: A Patient Journey Map Based on Qualitative Research.Current oncology (Toronto, Ont.) · 2024Article
- Developing questions to assess and measure patients' perceived survival benefit from adjuvant endocrine therapy in breast cancer: a mixed methods pilot study.Clinical and experimental medicine · 2024Article
- To Radiate or Not to Radiate After Breast-Conserving Surgery-Endocrine Therapy is the Question.Annals of surgical oncology · 2023Article
- Informing interventions to improve uptake of adjuvant endocrine therapy in women with breast cancer: a theoretical-based examination of modifiable influences on non-adherence.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2023Article
- Adapting an Evidence-Based Exercise and Education Program for Older Breast Cancer Survivors for the REJOIN Trial.Journal of aging and physical activity · 2023Review
- Impact of hormone therapy side effects on health-related quality of life, distress, and well-being of breast cancer survivors.Scientific reports · 2022Article
- Systematic adaptation of the adherence improving self-management strategy to support breast cancer survivors' adherence to adjuvant endocrine therapy: An intervention mapping approach.European journal of cancer care · 2022Review
- Patient, provider, and nurse preferences of patient reported outcomes (PRO) and side effect management during cancer treatment of underrepresented racial and ethnic minority groups, rural and economically disadvantaged patients: a mixed methods study.Cancer causes & control : CCC · 2022Article
- Association of Endocrine Therapy Initiation Timeliness With Adherence and Continuation in Low-Income Women With Breast Cancer.JAMA network open · 2022Article
- Endocrine therapy initiation among women with stage I-III invasive, hormone receptor-positive breast cancer from 2001-2016.Breast cancer research and treatment · 2022Article
- Association of treatment-emergent symptoms identified by patient-reported outcomes with adjuvant endocrine therapy discontinuation.NPJ breast cancer · 2022Article
- Effects of Endocrine Therapy on Cognitive Function in Patients with Breast Cancer: A Comprehensive Review.Cancers · 2022Review
Corrections and comments
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Authors and funding
6 authors at 4 institutions in 1 country.
Funding
Abstract
PURPOSE/
objectivesAdjuvant endocrine therapy (AET) has been shown to improve survival in hormone receptor-positive breast cancer survivors, but as many as half do not complete recommended treatment. Management of medication-related side effects and engagement with providers are two potentially modifiable factors, but their associations with adherence are not well understood. The aims were to build on survey results to qualitatively explore survivors' experiences with prescribed AET to (a) describe appraisal and management of AET side effects and (b) deconstruct decisions to initiate, discontinue, or maintain AET. . RESEARCH APPROACH: The authors used a mixed-methods explanatory sequence research design with a qualitative emphasis. .
settingSurvivors were recruited from a clinical cancer registry maintained at the University of Texas Southwestern Medical Center, which includes the Harold C. Simmons Comprehensive Cancer Center (National Cancer Institute-designated), in Dallas. .
participants452 survivors completed a survey, and 30 took part in telephone interviews. . METHODOLOGIC APPROACH: Qualitative methods were used in which the authors recorded and transcribed interviews for analysis and used open coding to reduce data into themes. .
findingsAmong adherent survivors, the themes of tolerance of side effects and perseverance were strong. Nonadherent survivors expressed more difficulty managing side effects and perceived fewer benefits when side effects were bothersome. The most common side effects mentioned by all survivors were menopausal symptoms and joint pain; less common side effects were cognitive decline and cardiac distress. Some sought advice from their oncology team. Nonadherent survivors appeared initially motivated to maintain AET but identified a tolerance limit for side effects after which a provider's recommendation was less influential in their decision to maintain or discontinue AET. .
interpretationThis study elucidated adherence as a complex continuum of behaviors, appraisals, and decision points. These insights may be particularly useful in counseling survivors taking AET and promoting timely delivery of clinical interventions to enhance adherence. . IMPLICATIONS FOR NURSING: Nurses should be involved in the planning and implementation of clinical interventions to manage side effects and other barriers to AET adherence.
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