Abstract
Since the rate of persistence to adjuvant endocrine therapy such as 5-year aromatase inhibitors (AI) would decrease over time in patients with hormone-sensitive breast cancer, it is necessary to investigate if a patient support program could modify patients’ beliefs and improve their persistence to AI treatment. This was a prospective, multicenter, controlled, observational study to evaluate the efficacy of a patient support program in improving postmenopausal patients’ persistence to adjuvant AI medication for early stage breast cancer (NCT00769080). The primary objective was to compare the rates of 1-year persistence to upfront adjuvant AI for patients in the two observational arms (standard treatment group and standard treatment plus patient support program group). In this study, 262 patients were enrolled in the standard treatment group and 241 patients in the standard treatment plus patient support program group. The mean 1-year persistence rates were 95.9 and 95.8 % for the standard treatment group and the standard treatment plus patient support program group, respectively (P = 0.95). The mean times to treatment discontinuation were 231.2 days in the standard treatment group and 227.8 days in the standard treatment plus patient support program group, with no statistically significant difference between the two groups (P = 0.96). There was also no statistically significant difference in the reason for treatment discontinuation (P = 0.32). There was a significant relationship between the patient centered care questionnaire and poor persistence (odds ratio = 3.9; 95 % CI, 1.1–13.7; P = 0.035), suggesting that the persistence rate of patients with whom the doctor always or usually spends time is greater than that of patients with whom the doctor sometimes or never spends time. Patients’ persistence to adjuvant AI medication for postmenopausal, early stage breast cancer is relatively high in the first year and is not significantly increased by adding a patient support program to standard treatment.
Similar content being viewed by others
References
Claxton AJ, Cramer J, Pierce C (2001) A systematic review of the associations between dose regimens and medication compliance. Clin Ther 23:1296–1310
Partridge AH, Avorn J, Wang PS, Winer EP (2002) Adherence to therapy with oral antineoplastic agents. J Natl Cancer Inst 94:652–661
Lash TL, Fox MP, Westrup JL, Fink AK, Silliman RA (2006) Adherence to tamoxifen over the five-year course. Breast Cancer Res Treat 99:215–220
Barron TI, Connolly R, Bennett K, Feely J, Kennedy MJ (2007) Early discontinuation of tamoxifen: a lesson for oncologists. Cancer 109:832–839
Fink AK, Gurwitz J, Rakowski W, Guadagnoli E, Silliman RA (2004) Patient beliefs and tamoxifen discontinuance in older women with estrogen receptor-positive breast cancer. J Clin Oncol 22:3309–3315
Partridge AH, Wang PS, Winer EP, Avorn J (2003) Nonadherence to adjuvant tamoxifen therapy in women with primary breast cancer. J Clin Oncol 21:602–606
Partridge AH, LaFountain A, Mayer E, Taylor BS, Winer E, Asnis-Alibozek A (2008) Adherence to initial adjuvant anastrozole therapy among women with early-stage breast cancer. J Clin Oncol 26:556–562
DiMatteo MR (1994) Enhancing patient adherence to medical recommendations. J Am Med Assoc 271(79):83
Wengstrom Y, Aapro M, di Priolo SL, Cannon H, Georgiou V (2007) Patients’ knowledge and experience of adjuvant endocrine therapy for early breast cancer: a European study. Breast 16:462–468
Arican A, Ozaslan C, Benekli M, Gulcelik M, Sevinc A, Altundag M, Bese N (2011) The impact of educational material (EM) on compliance and persistence rates with adjuvant aromatase inhibitor (AI) treatment: first year data from Turkish arm of the CARIATIDE study. San Antonio breast cancer symposium P5-08-02. University of Texas Health Science Center, San Antonio
Lück H, Hadji P, Harbeck N, Jackisch C, Blettner M, Glados M, Terhaag J, Hackenberg R, Goehler T, Zaun S, von Fircks AR, Kreienberg R (2011) 24-month follow-up from the patient’s anastrozole compliance to therapy (PACT) program evaluating the influence of a standardized information service on compliance in postmenopausal women with early breast cancer. J Clin Oncol 29:s526
Acknowledgments
This research is supported by grants from the National Natural Science Foundation of China (30971143, 30972936, 81001169, 81102003), the Shanghai United Developing Technology Project of Municipal Hospitals (SHDC12010116), the Key Clinical Program of the Ministry of Health (2010–2012), the Zhuo-Xue Project of Fudan University, and the Shanghai Committee of Science and Technology Fund for 2011 Qimingxing Project (11QA1401400). The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Conflicts of interest
The authors have declared that no competing interests exist.
Author information
Authors and Affiliations
Corresponding author
Additional information
Ke-Da Yu, Ying Zhou, Guang-Yu Liu and Bin Li are contributed equally to this work.
Rights and permissions
About this article
Cite this article
Yu, KD., Zhou, Y., Liu, GY. et al. A prospective, multicenter, controlled, observational study to evaluate the efficacy of a patient support program in improving patients’ persistence to adjuvant aromatase inhibitor medication for postmenopausal, early stage breast cancer. Breast Cancer Res Treat 134, 307–313 (2012). https://doi.org/10.1007/s10549-012-2059-8
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10549-012-2059-8