Evidence map›Paper›PMID 31975315›Full record

ArticleBreast cancer research and treatment2020

Adjuvant endocrine therapy for breast cancer patients: impact of a health system outreach program to improve adherence.

Catherine Lee, Devon K Check, Leslie Manace Brenman, Lawrence H Kushi, Mara M Epstein, Christine Neslund-Dudas, Pamala A Pawloski, Ninah Achacoso, Cecile Laurent, Louis Fehrenbacher and 1 more

Abstract read
In one paragraph

Article in Breast cancer research and treatment, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 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

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. A Systematic Review and Meta-Analysis of Interventions to Promote Adjuvant Endocrine Therapy Adherence Among Breast Cancer Survivors.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2023
    Pooled it
  2. Article
  3. Article
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

11 authors.

Catherine LeeDivision of Research, Kaiser Permanente Northern California, Oakland, CA, USA. catherine.lee@kp.org.ORCID http://orcid.org/0000-0003-0008-9052
Devon K CheckDepartment of Population Health Sciences, Duke University School of Medicine, Duke Cancer Institute, Durham, NC, USA.
Leslie Manace BrenmanKaiser Permanente Northern California Breast Cancer Tracking System, Oakland, CA, USA.
Lawrence H KushiDivision of Research, Kaiser Permanente Northern California, Oakland, CA, USA.
Mara M EpsteinMeyers Primary Care Institute and the Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA.
Christine Neslund-DudasDepartment of Public Health Sciences, Henry Ford Health System and the Henry Ford Cancer Institute, Detroit, MI, USA.
Pamala A PawloskiHealthPartners Institute, Minneapolis, MN, USA.
Ninah AchacosoDivision of Research, Kaiser Permanente Northern California, Oakland, CA, USA.
Cecile LaurentDivision of Research, Kaiser Permanente Northern California, Oakland, CA, USA.
Louis FehrenbacherKaiser Permanente Northern California Medical Oncology, Oakland, CA, USA.
Laurel A HabelDivision of Research, Kaiser Permanente Northern California, Oakland, CA, USA.

Funding

CRN4: Cancer Research Resources & Collaboration in Integrated Health Care SystemsU24CA171524 · NCI · KAISER FOUNDATION RESEARCH INSTITUTE · PI KUSHI, LAWRENCE H · 2012 to 2016
$16.0M
NCI NIH HHS U24 CA171524
6 · The paper itself

Abstract

purposeReports suggest that up to 50% of women with hormone receptor-positive (HR+) breast cancer (BC) do not complete the recommended 5 years of adjuvant endocrine therapy (AET). We examined the impact of an outreach program at Kaiser Permanente Northern California (KPNC) on adherence and discontinuation of AET among patients who initiated AET.

methodsWe assembled a retrospective cohort of all KPNC patients diagnosed with HR+, stage I-III BC initiating AET before (n = 4287) and after (n = 3580) implementation of the outreach program. We compared adherence proportions and discontinuation rates before and after program implementation, both crude and adjusted for age, race/ethnicity, education, income, and stage. We conducted a pooled analysis of data from six Cancer Research Network (CRN) sites that had not implemented programs for improving AET adherence, using identical methods and time periods, to assess possible secular trends.

resultsIn the pre-outreach period, estimated adherence in years 1, 2, and 3 following AET initiation was 75.2%, 71.0%, and 67.3%; following the outreach program, the estimates were 79.4%, 75.6%, and 72.2% (p-values < .0001 for pairwise comparisons). Results were comparable after adjusting for clinical and demographic factors. The estimated cumulative incidence of discontinuation was 0.22 (0.21-0.24) and 0.18 (0.17-0.19) at 3 years for pre- and post-outreach groups (p-value < .0001). We found no evidence of an increase in adherence between the study periods at the CRN sites with no AET adherence program.

conclusionAdherence and discontinuation after AET initiation improved modestly following implementation of the outreach program.

Indexed as

AdultAgedAged, 80 and overAntineoplastic Agents, HormonalBreast NeoplasmsCaliforniaChemotherapy, AdjuvantCombined Modality TherapyFemaleHealth Plan ImplementationHumansMedication AdherenceMiddle AgedNeoplasm StagingQuality ImprovementRegional Medical ProgramsAntineoplastic Agents, HormonalAdherenceAdjuvant endocrine therapyBreast cancerDiscontinuationInterventionOutreach

Identifiers

PMID31975315
PMCPMC7035197

What OpenQuestion holds

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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.