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- Title
Low Adherence to Upfront and Extended Adjuvant Letrozole Therapy among Early Breast Cancer Patients in a Clinical Practice Setting.
- Authors
Lee, Hye-Suk; Lee, Ju-Yeun; Ah, Young-Mi; Kim, Hyang-Sook; Im, Seock-Ah; Noh, Dong-Young; Lee, Byung Koo
- Abstract
Objective: The aim of this study was to investigate the prevalence and causes of early discontinuation and non-adherence to upfront and extended adjuvant letrozole therapy in breast cancer patients. Methods: Adherence was assessed using medical charts and longitudinal pharmacy records of 609 patients who initiated adjuvant letrozole between January 2002 and April 2011. A Cox proportional hazards regression model was adopted to identify potential predictors of non-adherence. Results: The overall adherence rate after 1 year of therapy was 79.5%, with cumulative rates declining to 63.7% after 3 years and 57.1% after 5 years. A significantly lower rate of adherence in the extended adjuvant group was observed compared with the upfront adjuvant group (49.0 vs. 72.5%, p < 0.001). Adverse events (50.4%) were the major cause of early discontinuation, with musculoskeletal pain (73.2%) being the single most cited reason. Additional factors correlating with non-adherence in the upfront adjuvant group included a delay in initiation of adjuvant hormone therapy, breast-conserving surgery, calcium supplements, bisphosphonate therapy and concomitant medication for co-morbidity. Conclusions: We observed that approximately 57% of patients fully adhered to letrozole therapy over a 5-year treatment period, and that the adherence to extended letrozole was meaningfully lower than the upfront adjuvant letrozole in a clinical practice setting. © 2014 S. Karger AG, Basel
- Subjects
SOUTH Korea; ANTINEOPLASTIC agents; BREAST tumors; CONFIDENCE intervals; HORMONE therapy; LONGITUDINAL method; MEDICAL records; MULTIVARIATE analysis; PATIENT compliance; PROPORTIONAL hazards models; RETROSPECTIVE studies; DATA analysis software; DESCRIPTIVE statistics; KAPLAN-Meier estimator
- Publication
Oncology, 2014, Vol 86, Issue 5/6, p340
- ISSN
0030-2414
- Publication type
Article
- DOI
10.1159/000360702