Comparison of adherence to antiestrogen therapy in patients with early breast cancer followed at tertiary centers versus through family physicians and primary surgeons: a practice review

摘要

Background: Poor adherence or noncompliance to pharmacologic therapies in chronic diseases is a major clinical problem. Adherence to adjuvant antiestrogen therapies among patients with early breast cancer (EBC) is variable, as reported in different clinical trials. Canadian cancer centers, at present, frequently refer patients with EBC on adjuvant antiestrogen therapy back to their surgeons and family doctors for follow-up. In order to find any difference in adherence for such patients, we reviewed patients followed by their primary surgeons and family doctors (peripheral cohort) for adherence and compared them with patients regularly followed in the cancer center (central cohort). Patients & methods: Women with EBC receiving antiestrogen therapy were identified from the breast cancer database at the London Regional Cancer Program. A telephone interview was conducted with patients. We assumed that adherence in the central cohort will be 20% higher than the peripheral cohort. Patients were considered adherent if they took more than 80% of the prescribed medication, nonadherent if they took less than 50% of the prescribed medication and semiadherent if they took 50-80% of the prescribed medication. Results: We recruited a total of 160 patients (80 patients in each cohort). Seventy-seven (96.3%) patients in the central cohort were reportedly adherent and 76 (95%) patients were adherent in the peripheral cohort.