Impact of Preexisting Mental Illness on Breast Cancer Endocrine Therapy Adherence
| Autor: | Ryan M. Carnahan, Brian J. Smith, Elizabeth A. Chrischilles, Jess G. Fiedorowicz, Cole B. Haskins, Bradley D. McDowell, Robert B. Wallace |
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| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
0301 basic medicine
Cancer Research medicine.medical_specialty Antineoplastic Agents Hormonal Breast Neoplasms Medicare Article Medication Adherence Cohort Studies 03 medical and health sciences 0302 clinical medicine Breast cancer Internal medicine medicine Humans Depression (differential diagnoses) Aged Retrospective Studies Aged 80 and over business.industry Mental Disorders Cancer Retrospective cohort study medicine.disease United States Discontinuation 030104 developmental biology Oncology 030220 oncology & carcinogenesis Cohort Anxiety Female medicine.symptom business Cohort study SEER Program |
| Popis: | PURPOSE: Patients with estrogen receptor positive (ER+) breast cancer are often non-adherent to endocrine therapies, despite clear survival benefits. We utilized a nationally representative cancer cohort to examine the role of specific mental illnesses on endocrine therapy adherence. METHODS: Using the SEER-Medicare database, we included 21,894 women aged 68+ at their first surgically treated stage I-IV ER+ breast cancer during 2007–2013. All had continuous fee-for-service Medicare Parts A and B for 36+ months before, 18+ months after diagnosis, and continuous Part D for 4+ months before, 18+ after diagnosis. Mental illness was defined as occurring in the 36 months prior to cancer onset. We analyzed endocrine therapy adherence, initiation, and discontinuation using longitudinal linear and Cox regression models. RESULTS: Unipolar depression (11.0%), anxiety (9.5%), non-schizophrenia psychosis (4.6%), and dementias (4.6%) were the most prevalent diagnoses. Endocrine therapies were initiated by 80.0% of women. Among those with at least one year of use, 28.0% were non-adherent ( |
| Databáze: | OpenAIRE |
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