Medication adherence in breast cancer: why do patients skip drugs?
Medication adherence in breast cancer: why do patients skip drugs?
17 Aug 2015Breast cancer patients who report more side effects of their hormone therapy drugs and less confidence communicating with their doctors are more likely to intentionally or unintentionally miss a dose, according to a new study.
“There are many reasons that women may choose not to take the medicine,” said lead author Gretchen Kimmick of Duke Cancer Institute at Duke University Medical Center in Durham, North Carolina. “The most common reason is probably because they notice side effects.”
Survey on side effects and patient-doctor confidentiality
The researchers studied 112 postmenopausal women with early stage, hormone-receptor positive breast cancer who had completed surgery, chemotherapy or radiation and were currently taking an endocrine therapy medication like tamoxifen. Endocrine therapy is an important part of treatment for some types of early breast cancer. However, it can cause side effects like nausea, hot flashes and headaches.
The women answered survey questions about their levels of general pain, fatigue, hot flashes or night sweats, and nerve pain over the previous week. They also rated their confidence in their ability to take the medicine as prescribed, their ability to communicate with their doctors, their beliefs about hormone therapy, and their medication behavior.
Why did women miss doses of their medication?
Women rated from “never” to “very often” the frequency with which they forgot to take medication, skipped doses, or reduced or stopped medication when feeling better or when feeling worse. On average, the women had been receiving endocrine therapy for about three years. Analyzing their answers, the researchers found that:
- More than half said they had missed some doses unintentionally, due to having a busy day, being away from home, or problems getting refills.
- A third said they had intentionally skipped or changed the dose, often because they felt worse or had side effects, and sometimes because of cost.
- Women with less confidence in taking their medications and less confidence talking with their doctors were more like to miss doses.
“Women who don’t understand the benefits of the medicines may be less motivated to take them”
According to Colin McCowan, professor of health informatics at the University of Glasgow, who wasn’t involved in the study, women might not usually receive advice, support and monitoring for adherence during endocrine therapy.
Failing to take these drugs as directed increases the risk of cancer recurrence, death, lower quality of life and also higher health service costs, said McCowan. He added that the side effects can cause “huge disruption to women's lives,” and women who don’t understand the benefits of the medicines may be less motivated to take them.
Having regular conversations with your doctors about taking endocrine therapy and any side effects, and trying to incorporate the pills into your daily routine, may help patients stick to the medication, he said.
Source: Reuters