ASPO Abstracts
The Role of Race and Patient Reported Symptoms in Regimen Adherence to Adjuvant Endocrine Therapy
Category: Cancer Health Disparities
Conference Year: 2019
Abstract Body:
Background Adjuvant endocrine therapy (AET) improves outcomes of hormone receptor positive (HR+)breast cancer (BC), yet many women fail to take AET as prescribed. This study aimed to examine the role of raceand AET-related symptoms on AET regimen adherence in Black and White survivors. MethodsWomen eligible for the Women’s Hormonal Initiation and Persistence (WHIP) study werediagnosed with non-recurrent HR+ BC and initiated AET within 18 months of their diagnosis. Trained clinicalresearch assistants consented participants, abstracted medical records and conducted standardized surveyscollecting individual (e.g., race, age), medication-related (e.g., hot flashes), lifestyle (sitting time,physical activity), interpersonal (e.g., communication) and psychosocial (medication beliefs) factors. Regimen adherence was scoredusing validated items to assess daily regimen behaviors and categorized as high vs. moderate/lowadherence. Stepwise multivariable logistic regression was employed to test associations of factors withregimen adherence; five individual models were estimated per symptom domain (vasomotor, gynecological, etc.). ResultsThe analytical sample included Black (n=160) and White (n=394) survivors. Sixty-twopercent of women were taking Aromatase Inhibitors (AIs), while the remaining were on Tamoxifen; 63% reportedhigh adherence. Black (vs. White) women reported more overall AET-related symptoms (p<0.001) and more symptomsfor four of the five domains (e.g., vasomotor). In multivariable models, Black (vs. White) women, those takingAIs (vs. Tamoxifen), and women with more symptoms were less likely to be high adherers (p=<.05). Higher BMI(OR: 1.81; 95% CI: 1.27-2.91; p<0.01) and less sedentary time (OR: 1. 64; 95% CI: 1.11-2.44; p<0.05) wereassociated with higher adherence. Black women (vs. White women) were significantly less likely to adhere in allsymptom-based models. Conclusion Race differences in AET adherence persisted after adjusting for symptoms and otherfactors. Interventions that prioritize Black women and symptom management are needed. Longitudinal studies are neededto disentangle relationships between lifestyle-related factors and adherence behaviors.
Keywords: Regimen AdherenceAdjuvant Endocrine Therapy