Clinical factors associated with patterns of endocrine therapy adherence in premenopausal breast cancer patients

Kirsten M Woolpert; Julie A Schmidt; Thomas P Ahern; Cathrine F Hjorth; Dóra K Farkas; Bent Ejlertsen; Lindsay J Collin; Timothy L Lash; Deirdre P Cronin-Fenton

doi:10.1186/s13058-024-01819-4

Clinical factors associated with patterns of endocrine therapy adherence in premenopausal breast cancer patients

Kirsten M Woolpert, Julie A Schmidt, Thomas P Ahern, Cathrine F Hjorth, Dóra K Farkas, Bent Ejlertsen, Lindsay J Collin, Timothy L Lash, Deirdre P Cronin-Fenton

Department of Clinical Medicine - Department of Clinical Epidemiology

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

1 Citation (Scopus)

Abstract

INTRODUCTION: Patients with hormone receptor positive breast cancer are recommended at least five years of adjuvant endocrine therapy, but adherence to this treatment is often suboptimal. We investigated longitudinal trends in adjuvant endocrine therapy (AET) adherence among premenopausal breast cancer patients and identified clinical characteristics, including baseline comorbidities and non-cancer chronic medication use, associated with AET adherence.

METHODS: We included stage I-III premenopausal breast cancer patients diagnosed during 2002-2011 and registered in the Danish Breast Cancer Group clinical database who initiated AET. We used group-based trajectory modeling to describe AET adherence patterns. We also linked patients to Danish population-based registries and fit multinomial logistic models to compute odds ratios (ORs) and 95% confidence intervals (95% CIs) associating clinical characteristics with AET adherence patterns.

RESULTS: We identified three adherence patterns among 4,353 women-high adherers (57%), slow decliners (36%), and rapid decliners (6.9%). Women with stage I disease (vs. stage II; OR: 1.9, 95% CI 1.5, 2.5), without chemotherapy (vs. chemotherapy; OR: 4.3, 95% CI 3.0, 6.1), with prevalent comorbid disease (Charlson Comorbidity Index score ≥ 1 vs. 0; OR: 1.6, 95% CI 1.1, 2.3), and with a history of chronic non-cancer medication use (vs. none; OR: 1.3, 95% CI 1.0, 1.8) were more likely to be rapid decliners compared with high adherers.

CONCLUSIONS: Women with stage I cancer, no chemotherapy, higher comorbidity burden, and history of chronic non-cancer medication use were less likely to adhere to AET. Taking steps to promote adherence in these groups of women may reduce their risk of recurrence.

Original language	English
Journal	Breast Cancer Research
Volume	26
Issue	1
Pages (from-to)	59
Number of pages	1
ISSN	1465-5411
DOIs	https://doi.org/10.1186/s13058-024-01819-4
Publication status	Published - Apr 2024

Keywords

Humans
Female
Breast Neoplasms/drug therapy
Chemotherapy, Adjuvant
Antineoplastic Agents, Hormonal/therapeutic use
Medication Adherence
Retrospective Studies
Premenopausal breast cancer
Adherence
Comorbidities
Clinical characteristics
Adjuvant endocrine therapy
Chronic medication use

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title = "Clinical factors associated with patterns of endocrine therapy adherence in premenopausal breast cancer patients",

abstract = "INTRODUCTION: Patients with hormone receptor positive breast cancer are recommended at least five years of adjuvant endocrine therapy, but adherence to this treatment is often suboptimal. We investigated longitudinal trends in adjuvant endocrine therapy (AET) adherence among premenopausal breast cancer patients and identified clinical characteristics, including baseline comorbidities and non-cancer chronic medication use, associated with AET adherence.METHODS: We included stage I-III premenopausal breast cancer patients diagnosed during 2002-2011 and registered in the Danish Breast Cancer Group clinical database who initiated AET. We used group-based trajectory modeling to describe AET adherence patterns. We also linked patients to Danish population-based registries and fit multinomial logistic models to compute odds ratios (ORs) and 95% confidence intervals (95% CIs) associating clinical characteristics with AET adherence patterns.RESULTS: We identified three adherence patterns among 4,353 women-high adherers (57%), slow decliners (36%), and rapid decliners (6.9%). Women with stage I disease (vs. stage II; OR: 1.9, 95% CI 1.5, 2.5), without chemotherapy (vs. chemotherapy; OR: 4.3, 95% CI 3.0, 6.1), with prevalent comorbid disease (Charlson Comorbidity Index score ≥ 1 vs. 0; OR: 1.6, 95% CI 1.1, 2.3), and with a history of chronic non-cancer medication use (vs. none; OR: 1.3, 95% CI 1.0, 1.8) were more likely to be rapid decliners compared with high adherers.CONCLUSIONS: Women with stage I cancer, no chemotherapy, higher comorbidity burden, and history of chronic non-cancer medication use were less likely to adhere to AET. Taking steps to promote adherence in these groups of women may reduce their risk of recurrence.",

keywords = "Humans, Female, Breast Neoplasms/drug therapy, Chemotherapy, Adjuvant, Antineoplastic Agents, Hormonal/therapeutic use, Medication Adherence, Retrospective Studies, Premenopausal breast cancer, Adherence, Comorbidities, Clinical characteristics, Adjuvant endocrine therapy, Chronic medication use",

author = "Woolpert, {Kirsten M} and Schmidt, {Julie A} and Ahern, {Thomas P} and Hjorth, {Cathrine F} and Farkas, {D{\'o}ra K} and Bent Ejlertsen and Collin, {Lindsay J} and Lash, {Timothy L} and Cronin-Fenton, {Deirdre P}",

note = "{\textcopyright} 2024. The Author(s).",

year = "2024",

month = apr,

doi = "10.1186/s13058-024-01819-4",

language = "English",

volume = "26",

pages = "59",

journal = "Breast Cancer Research",

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Clinical factors associated with patterns of endocrine therapy adherence in premenopausal breast cancer patients. / Woolpert, Kirsten M ; Schmidt, Julie A ; Ahern, Thomas P et al.
In: Breast Cancer Research, Vol. 26, No. 1, 04.2024, p. 59.

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

TY - JOUR

T1 - Clinical factors associated with patterns of endocrine therapy adherence in premenopausal breast cancer patients

AU - Woolpert, Kirsten M

AU - Schmidt, Julie A

AU - Ahern, Thomas P

AU - Hjorth, Cathrine F

AU - Farkas, Dóra K

AU - Ejlertsen, Bent

AU - Collin, Lindsay J

AU - Lash, Timothy L

AU - Cronin-Fenton, Deirdre P

PY - 2024/4

Y1 - 2024/4

N2 - INTRODUCTION: Patients with hormone receptor positive breast cancer are recommended at least five years of adjuvant endocrine therapy, but adherence to this treatment is often suboptimal. We investigated longitudinal trends in adjuvant endocrine therapy (AET) adherence among premenopausal breast cancer patients and identified clinical characteristics, including baseline comorbidities and non-cancer chronic medication use, associated with AET adherence.METHODS: We included stage I-III premenopausal breast cancer patients diagnosed during 2002-2011 and registered in the Danish Breast Cancer Group clinical database who initiated AET. We used group-based trajectory modeling to describe AET adherence patterns. We also linked patients to Danish population-based registries and fit multinomial logistic models to compute odds ratios (ORs) and 95% confidence intervals (95% CIs) associating clinical characteristics with AET adherence patterns.RESULTS: We identified three adherence patterns among 4,353 women-high adherers (57%), slow decliners (36%), and rapid decliners (6.9%). Women with stage I disease (vs. stage II; OR: 1.9, 95% CI 1.5, 2.5), without chemotherapy (vs. chemotherapy; OR: 4.3, 95% CI 3.0, 6.1), with prevalent comorbid disease (Charlson Comorbidity Index score ≥ 1 vs. 0; OR: 1.6, 95% CI 1.1, 2.3), and with a history of chronic non-cancer medication use (vs. none; OR: 1.3, 95% CI 1.0, 1.8) were more likely to be rapid decliners compared with high adherers.CONCLUSIONS: Women with stage I cancer, no chemotherapy, higher comorbidity burden, and history of chronic non-cancer medication use were less likely to adhere to AET. Taking steps to promote adherence in these groups of women may reduce their risk of recurrence.

AB - INTRODUCTION: Patients with hormone receptor positive breast cancer are recommended at least five years of adjuvant endocrine therapy, but adherence to this treatment is often suboptimal. We investigated longitudinal trends in adjuvant endocrine therapy (AET) adherence among premenopausal breast cancer patients and identified clinical characteristics, including baseline comorbidities and non-cancer chronic medication use, associated with AET adherence.METHODS: We included stage I-III premenopausal breast cancer patients diagnosed during 2002-2011 and registered in the Danish Breast Cancer Group clinical database who initiated AET. We used group-based trajectory modeling to describe AET adherence patterns. We also linked patients to Danish population-based registries and fit multinomial logistic models to compute odds ratios (ORs) and 95% confidence intervals (95% CIs) associating clinical characteristics with AET adherence patterns.RESULTS: We identified three adherence patterns among 4,353 women-high adherers (57%), slow decliners (36%), and rapid decliners (6.9%). Women with stage I disease (vs. stage II; OR: 1.9, 95% CI 1.5, 2.5), without chemotherapy (vs. chemotherapy; OR: 4.3, 95% CI 3.0, 6.1), with prevalent comorbid disease (Charlson Comorbidity Index score ≥ 1 vs. 0; OR: 1.6, 95% CI 1.1, 2.3), and with a history of chronic non-cancer medication use (vs. none; OR: 1.3, 95% CI 1.0, 1.8) were more likely to be rapid decliners compared with high adherers.CONCLUSIONS: Women with stage I cancer, no chemotherapy, higher comorbidity burden, and history of chronic non-cancer medication use were less likely to adhere to AET. Taking steps to promote adherence in these groups of women may reduce their risk of recurrence.

KW - Humans

KW - Female

KW - Breast Neoplasms/drug therapy

KW - Chemotherapy, Adjuvant

KW - Antineoplastic Agents, Hormonal/therapeutic use

KW - Medication Adherence

KW - Retrospective Studies

KW - Premenopausal breast cancer

KW - Adherence

KW - Comorbidities

KW - Clinical characteristics

KW - Adjuvant endocrine therapy

KW - Chronic medication use

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U2 - 10.1186/s13058-024-01819-4

DO - 10.1186/s13058-024-01819-4

M3 - Journal article

C2 - 38589932

SN - 1465-5411

VL - 26

SP - 59

JO - Breast Cancer Research

JF - Breast Cancer Research

IS - 1

ER -

Clinical factors associated with patterns of endocrine therapy adherence in premenopausal breast cancer patients

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