Facilitators and barriers to medication adherence with adjuvant endocrine therapy in women with breast cancer: a structural equation modelling approach
Purpose To identify a structure to explain the relationship between socio-clinico factors, necessity-concerns beliefs, and perceived barriers to adherence with adjuvant endocrine therapy (AET) amongst women with breast cancer. Methods Participants were 244 patients with early-stage breast cancer rec...
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| Veröffentlicht in: | Breast cancer research and treatment 2021-08, Vol.188 (3), p.779-788 |
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| creator | Tan, Eng Hooi Wong, Andrea Li Ann Tan, Chuan Chien Wong, Patrick Tan, Sing Huang Ang, Li En Yvonne Lim, Siew Eng Chong, Wan Qin Ho, Jingshan Lee, Soo Chin Tai, Bee Choo |
| description | Purpose
To identify a structure to explain the relationship between socio-clinico factors, necessity-concerns beliefs, and perceived barriers to adherence with adjuvant endocrine therapy (AET) amongst women with breast cancer.
Methods
Participants were 244 patients with early-stage breast cancer recruited from two tertiary hospitals from May 2015 to December 2018 who completed questionnaires on medication adherence (Simplified Medication Adherence Questionnaire), necessity-concerns beliefs (Beliefs about Medicine Questionnaire), and barriers to adherence (Adherence Starts with Knowledge Questionnaire). Socio-clinico variables were collected via interview and medical records review. Structural equation modelling was applied to examine the relationships between these variables and possible mediating effects of necessity-concerns beliefs on adherence to AET.
Results
The median age of the study participants was 61 (range 32–80) years and the median duration on AET was 1.6 (IQR 1.2–2.6) years. Adherence was positively associated with age (
β
= 0.145, 95% CI: 0.011 to 0.279,
p
= 0.034) and negatively associated with barriers (
β
= − 0.381, 95% CI: − 0.511 to − 0.251,
p
|
| doi_str_mv | 10.1007/s10549-021-06204-9 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_proqu</sourceid><recordid>TN_cdi_proquest_miscellaneous_2522398165</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A668168892</galeid><sourcerecordid>A668168892</sourcerecordid><originalsourceid>FETCH-LOGICAL-c473t-4b7dea2d482dc7b5ed2d3e492c023f616d9049b61b0eadf3ff6da99fa5bb1c573</originalsourceid><addsrcrecordid>eNp9ksFuFSEUhidGY2v1BVwYEhPjZiowMzC4axqrJk3c6JqcgTP3cjMDt8C06ZP4unKdqq0xhgU58P0_cPir6iWjp4xS-S4x2rWqppzVVHDa1upRdcw62dSSM_m4OqZMyFr0VBxVz1LaUUqVpOppddQ0qu2llMfV9wswbnIZcoiJgLdkgBgdliIHMqN1BrILnoDdYkRvkNy4vC3lbrkGnwl6G0x0HkkuAOxvifPkJszoV3CICCkTA0Ua3xMgKcfF5CXCRPBqWc3nYHGanN8Q2O9jALN9Xj0ZYUr44m4-qb5dfPh6_qm-_PLx8_nZZW1a2eS6HaRF4LbtuTVy6NBy22CruKG8GQUTVtFWDYINFMGOzTgKC0qN0A0DM6VVJ9Xb1bcce7Vgynp2yZTLgMewJM07zhvVM9EV9PVf6C4s0ZfbFapVSqjmPrWBCbXzY8gRzMFUnwlRjPpe8UKd_oMqw-LsTPA4urL-QPDmnmCLMOVtCtNyaF96CPIVNDGkFHHU--hmiLeaUX2IjV5jo0ts9M_YaFVEr-6etgzlz39LfuWkAM0KpLLlNxj_vP0_tj8Akg3PRA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2549969365</pqid></control><display><type>article</type><title>Facilitators and barriers to medication adherence with adjuvant endocrine therapy in women with breast cancer: a structural equation modelling approach</title><source>SpringerNature Journals</source><creator>Tan, Eng Hooi ; Wong, Andrea Li Ann ; Tan, Chuan Chien ; Wong, Patrick ; Tan, Sing Huang ; Ang, Li En Yvonne ; Lim, Siew Eng ; Chong, Wan Qin ; Ho, Jingshan ; Lee, Soo Chin ; Tai, Bee Choo</creator><creatorcontrib>Tan, Eng Hooi ; Wong, Andrea Li Ann ; Tan, Chuan Chien ; Wong, Patrick ; Tan, Sing Huang ; Ang, Li En Yvonne ; Lim, Siew Eng ; Chong, Wan Qin ; Ho, Jingshan ; Lee, Soo Chin ; Tai, Bee Choo</creatorcontrib><description>Purpose
To identify a structure to explain the relationship between socio-clinico factors, necessity-concerns beliefs, and perceived barriers to adherence with adjuvant endocrine therapy (AET) amongst women with breast cancer.
Methods
Participants were 244 patients with early-stage breast cancer recruited from two tertiary hospitals from May 2015 to December 2018 who completed questionnaires on medication adherence (Simplified Medication Adherence Questionnaire), necessity-concerns beliefs (Beliefs about Medicine Questionnaire), and barriers to adherence (Adherence Starts with Knowledge Questionnaire). Socio-clinico variables were collected via interview and medical records review. Structural equation modelling was applied to examine the relationships between these variables and possible mediating effects of necessity-concerns beliefs on adherence to AET.
Results
The median age of the study participants was 61 (range 32–80) years and the median duration on AET was 1.6 (IQR 1.2–2.6) years. Adherence was positively associated with age (
β
= 0.145, 95% CI: 0.011 to 0.279,
p
= 0.034) and negatively associated with barriers (
β
= − 0.381, 95% CI: − 0.511 to − 0.251,
p
< 0.001). There was no effect of Necessity (
β
= 0.006, 95% CI: − 0.145 to 0.158,
p
= 0.933) or Concerns (
β
= 0.041, 95% CI: − 0.117 to 0.199,
p
= 0.614) on adherence. Necessity-concerns beliefs were also not significant mediators in the relationship between socio-clinico factors and medication adherence.
Conclusions
Older age and lower barriers to adherence were associated with higher adherence scores. Necessity-concerns beliefs did not have a significant effect on adherence as majority of the patients identified forgetfulness as a reason for non-adherence.</description><identifier>ISSN: 0167-6806</identifier><identifier>EISSN: 1573-7217</identifier><identifier>DOI: 10.1007/s10549-021-06204-9</identifier><identifier>PMID: 33948777</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Adjuvant treatment ; Analysis ; Breast cancer ; Cancer ; Cancer research ; Care and treatment ; Endocrine therapy ; Epidemiology ; Hospitals ; Medical records ; Medication adherence ; Medicine ; Medicine & Public Health ; Oncology ; Patient compliance ; Patients ; Questionnaires ; Structural equation modeling ; Women</subject><ispartof>Breast cancer research and treatment, 2021-08, Vol.188 (3), p.779-788</ispartof><rights>The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2021</rights><rights>COPYRIGHT 2021 Springer</rights><rights>The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2021.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c473t-4b7dea2d482dc7b5ed2d3e492c023f616d9049b61b0eadf3ff6da99fa5bb1c573</citedby><cites>FETCH-LOGICAL-c473t-4b7dea2d482dc7b5ed2d3e492c023f616d9049b61b0eadf3ff6da99fa5bb1c573</cites><orcidid>0000-0002-4420-7746</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10549-021-06204-9$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10549-021-06204-9$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33948777$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Tan, Eng Hooi</creatorcontrib><creatorcontrib>Wong, Andrea Li Ann</creatorcontrib><creatorcontrib>Tan, Chuan Chien</creatorcontrib><creatorcontrib>Wong, Patrick</creatorcontrib><creatorcontrib>Tan, Sing Huang</creatorcontrib><creatorcontrib>Ang, Li En Yvonne</creatorcontrib><creatorcontrib>Lim, Siew Eng</creatorcontrib><creatorcontrib>Chong, Wan Qin</creatorcontrib><creatorcontrib>Ho, Jingshan</creatorcontrib><creatorcontrib>Lee, Soo Chin</creatorcontrib><creatorcontrib>Tai, Bee Choo</creatorcontrib><title>Facilitators and barriers to medication adherence with adjuvant endocrine therapy in women with breast cancer: a structural equation modelling approach</title><title>Breast cancer research and treatment</title><addtitle>Breast Cancer Res Treat</addtitle><addtitle>Breast Cancer Res Treat</addtitle><description>Purpose
To identify a structure to explain the relationship between socio-clinico factors, necessity-concerns beliefs, and perceived barriers to adherence with adjuvant endocrine therapy (AET) amongst women with breast cancer.
Methods
Participants were 244 patients with early-stage breast cancer recruited from two tertiary hospitals from May 2015 to December 2018 who completed questionnaires on medication adherence (Simplified Medication Adherence Questionnaire), necessity-concerns beliefs (Beliefs about Medicine Questionnaire), and barriers to adherence (Adherence Starts with Knowledge Questionnaire). Socio-clinico variables were collected via interview and medical records review. Structural equation modelling was applied to examine the relationships between these variables and possible mediating effects of necessity-concerns beliefs on adherence to AET.
Results
The median age of the study participants was 61 (range 32–80) years and the median duration on AET was 1.6 (IQR 1.2–2.6) years. Adherence was positively associated with age (
β
= 0.145, 95% CI: 0.011 to 0.279,
p
= 0.034) and negatively associated with barriers (
β
= − 0.381, 95% CI: − 0.511 to − 0.251,
p
< 0.001). There was no effect of Necessity (
β
= 0.006, 95% CI: − 0.145 to 0.158,
p
= 0.933) or Concerns (
β
= 0.041, 95% CI: − 0.117 to 0.199,
p
= 0.614) on adherence. Necessity-concerns beliefs were also not significant mediators in the relationship between socio-clinico factors and medication adherence.
Conclusions
Older age and lower barriers to adherence were associated with higher adherence scores. Necessity-concerns beliefs did not have a significant effect on adherence as majority of the patients identified forgetfulness as a reason for non-adherence.</description><subject>Adjuvant treatment</subject><subject>Analysis</subject><subject>Breast cancer</subject><subject>Cancer</subject><subject>Cancer research</subject><subject>Care and treatment</subject><subject>Endocrine therapy</subject><subject>Epidemiology</subject><subject>Hospitals</subject><subject>Medical records</subject><subject>Medication adherence</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Oncology</subject><subject>Patient compliance</subject><subject>Patients</subject><subject>Questionnaires</subject><subject>Structural equation modeling</subject><subject>Women</subject><issn>0167-6806</issn><issn>1573-7217</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp9ksFuFSEUhidGY2v1BVwYEhPjZiowMzC4axqrJk3c6JqcgTP3cjMDt8C06ZP4unKdqq0xhgU58P0_cPir6iWjp4xS-S4x2rWqppzVVHDa1upRdcw62dSSM_m4OqZMyFr0VBxVz1LaUUqVpOppddQ0qu2llMfV9wswbnIZcoiJgLdkgBgdliIHMqN1BrILnoDdYkRvkNy4vC3lbrkGnwl6G0x0HkkuAOxvifPkJszoV3CICCkTA0Ua3xMgKcfF5CXCRPBqWc3nYHGanN8Q2O9jALN9Xj0ZYUr44m4-qb5dfPh6_qm-_PLx8_nZZW1a2eS6HaRF4LbtuTVy6NBy22CruKG8GQUTVtFWDYINFMGOzTgKC0qN0A0DM6VVJ9Xb1bcce7Vgynp2yZTLgMewJM07zhvVM9EV9PVf6C4s0ZfbFapVSqjmPrWBCbXzY8gRzMFUnwlRjPpe8UKd_oMqw-LsTPA4urL-QPDmnmCLMOVtCtNyaF96CPIVNDGkFHHU--hmiLeaUX2IjV5jo0ts9M_YaFVEr-6etgzlz39LfuWkAM0KpLLlNxj_vP0_tj8Akg3PRA</recordid><startdate>20210801</startdate><enddate>20210801</enddate><creator>Tan, Eng Hooi</creator><creator>Wong, Andrea Li Ann</creator><creator>Tan, Chuan Chien</creator><creator>Wong, Patrick</creator><creator>Tan, Sing Huang</creator><creator>Ang, Li En Yvonne</creator><creator>Lim, Siew Eng</creator><creator>Chong, Wan Qin</creator><creator>Ho, Jingshan</creator><creator>Lee, Soo Chin</creator><creator>Tai, Bee Choo</creator><general>Springer US</general><general>Springer</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>K9-</scope><scope>K9.</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-4420-7746</orcidid></search><sort><creationdate>20210801</creationdate><title>Facilitators and barriers to medication adherence with adjuvant endocrine therapy in women with breast cancer: a structural equation modelling approach</title><author>Tan, Eng Hooi ; Wong, Andrea Li Ann ; Tan, Chuan Chien ; Wong, Patrick ; Tan, Sing Huang ; Ang, Li En Yvonne ; Lim, Siew Eng ; Chong, Wan Qin ; Ho, Jingshan ; Lee, Soo Chin ; Tai, Bee Choo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c473t-4b7dea2d482dc7b5ed2d3e492c023f616d9049b61b0eadf3ff6da99fa5bb1c573</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Adjuvant treatment</topic><topic>Analysis</topic><topic>Breast cancer</topic><topic>Cancer</topic><topic>Cancer research</topic><topic>Care and treatment</topic><topic>Endocrine therapy</topic><topic>Epidemiology</topic><topic>Hospitals</topic><topic>Medical records</topic><topic>Medication adherence</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Oncology</topic><topic>Patient compliance</topic><topic>Patients</topic><topic>Questionnaires</topic><topic>Structural equation modeling</topic><topic>Women</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Tan, Eng Hooi</creatorcontrib><creatorcontrib>Wong, Andrea Li Ann</creatorcontrib><creatorcontrib>Tan, Chuan Chien</creatorcontrib><creatorcontrib>Wong, Patrick</creatorcontrib><creatorcontrib>Tan, Sing Huang</creatorcontrib><creatorcontrib>Ang, Li En Yvonne</creatorcontrib><creatorcontrib>Lim, Siew Eng</creatorcontrib><creatorcontrib>Chong, Wan Qin</creatorcontrib><creatorcontrib>Ho, Jingshan</creatorcontrib><creatorcontrib>Lee, Soo Chin</creatorcontrib><creatorcontrib>Tai, Bee Choo</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Breast cancer research and treatment</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Tan, Eng Hooi</au><au>Wong, Andrea Li Ann</au><au>Tan, Chuan Chien</au><au>Wong, Patrick</au><au>Tan, Sing Huang</au><au>Ang, Li En Yvonne</au><au>Lim, Siew Eng</au><au>Chong, Wan Qin</au><au>Ho, Jingshan</au><au>Lee, Soo Chin</au><au>Tai, Bee Choo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Facilitators and barriers to medication adherence with adjuvant endocrine therapy in women with breast cancer: a structural equation modelling approach</atitle><jtitle>Breast cancer research and treatment</jtitle><stitle>Breast Cancer Res Treat</stitle><addtitle>Breast Cancer Res Treat</addtitle><date>2021-08-01</date><risdate>2021</risdate><volume>188</volume><issue>3</issue><spage>779</spage><epage>788</epage><pages>779-788</pages><issn>0167-6806</issn><eissn>1573-7217</eissn><abstract>Purpose
To identify a structure to explain the relationship between socio-clinico factors, necessity-concerns beliefs, and perceived barriers to adherence with adjuvant endocrine therapy (AET) amongst women with breast cancer.
Methods
Participants were 244 patients with early-stage breast cancer recruited from two tertiary hospitals from May 2015 to December 2018 who completed questionnaires on medication adherence (Simplified Medication Adherence Questionnaire), necessity-concerns beliefs (Beliefs about Medicine Questionnaire), and barriers to adherence (Adherence Starts with Knowledge Questionnaire). Socio-clinico variables were collected via interview and medical records review. Structural equation modelling was applied to examine the relationships between these variables and possible mediating effects of necessity-concerns beliefs on adherence to AET.
Results
The median age of the study participants was 61 (range 32–80) years and the median duration on AET was 1.6 (IQR 1.2–2.6) years. Adherence was positively associated with age (
β
= 0.145, 95% CI: 0.011 to 0.279,
p
= 0.034) and negatively associated with barriers (
β
= − 0.381, 95% CI: − 0.511 to − 0.251,
p
< 0.001). There was no effect of Necessity (
β
= 0.006, 95% CI: − 0.145 to 0.158,
p
= 0.933) or Concerns (
β
= 0.041, 95% CI: − 0.117 to 0.199,
p
= 0.614) on adherence. Necessity-concerns beliefs were also not significant mediators in the relationship between socio-clinico factors and medication adherence.
Conclusions
Older age and lower barriers to adherence were associated with higher adherence scores. Necessity-concerns beliefs did not have a significant effect on adherence as majority of the patients identified forgetfulness as a reason for non-adherence.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>33948777</pmid><doi>10.1007/s10549-021-06204-9</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-4420-7746</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0167-6806 |
| ispartof | Breast cancer research and treatment, 2021-08, Vol.188 (3), p.779-788 |
| issn | 0167-6806 1573-7217 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2522398165 |
| source | SpringerNature Journals |
| subjects | Adjuvant treatment Analysis Breast cancer Cancer Cancer research Care and treatment Endocrine therapy Epidemiology Hospitals Medical records Medication adherence Medicine Medicine & Public Health Oncology Patient compliance Patients Questionnaires Structural equation modeling Women |
| title | Facilitators and barriers to medication adherence with adjuvant endocrine therapy in women with breast cancer: a structural equation modelling approach |
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