Sticking to the script: Breast cancer patients' decision making regarding oral endocrine therapy.

Autor: Wheeler SB; Department of Health Policy and Management, University of North Carolina at Chapel Hill, NC, USA; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, NC, USA. Electronic address: stephanie_wheeler@unc.edu., Roberts MC; Division of Pharmaceutical Outcomes and Policy, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, NC, USA., Waters AR; Department of Health Policy and Management, University of North Carolina at Chapel Hill, NC, USA; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, NC, USA., Bloom D; Department of Health Policy and Management, University of North Carolina at Chapel Hill, NC, USA., Peppercorn J; Dana Farber Cancer Center, Harvard University, MA, USA., Golin C; Department of Health Behavior, University of North Carolina at Chapel Hill, NC, USA., Reeder-Hayes KE; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, NC, USA; Division of Hematology and Oncology, University of North Carolina at Chapel Hill, NC, USA.
Jazyk: angličtina
Zdroj: Patient education and counseling [Patient Educ Couns] 2024 Oct; Vol. 127, pp. 108349. Date of Electronic Publication: 2024 Jun 11.
DOI: 10.1016/j.pec.2024.108349
Abstrakt: Objectives: We sought to understand why some women with early-stage breast cancer decide to forgo or discontinue endocrine therapy (ET), and to identify factors that might lead to greater acceptance of, and long-term adherence to, this treatment.
Methods: We conducted in-depth interviews with N = 53 stage I-III HR+ women who were either non-initiators of ET, initiators who discontinued or initiators who continued with variable daily patterns of adherence. An inductive content analysis was performed to explore the decision-making process of women prescribed ET.
Results: Qualitative analyses revealed 55 themes that drove complex decision making. The initiators generally trusted their physicians and did little research before starting the medication. Non-initiators were more suspicious of the medical system, believing that ET presented more risks than benefits. Most discontinuers stopped ET because of side effects. Both non-initiators and discontinuers indicated that push-back from their physicians could have changed their decision. Stories and social support were important in decision making.
Conclusions: Although ET can significantly reduce the risk of breast cancer recurrence, substantial barriers prevent many women from initiating or continuing it.
Practice Implications: Physicians have powerful influence over patients' decisions to initiate ET and can be important levers for motivating patients to persist.
Competing Interests: Declaration of Competing Interest The authors report no conflicts of interest.
(Copyright © 2024 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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