Cancer treatment adherence among low‐income women with breast or gynecologic cancer: A randomized controlled trial of patient navigation
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BACKGROUND: The authors implemented a controlled, randomized trial that compared 2 interventions: the provision of written resource navigation information (enhanced usual care [EUC]) versus written information plus patient navigation (TPN) aimed at improving adjuvant treatment adherence and follow‐up among 487 low‐income, predominantly Hispanic women with breast cancer or gynecologic cancer. METHODS: Women were randomized to receive either TPN or EUC; and chemotherapy, radiation therapy, hormone therapy, and follow‐up were assessed over 12 months. Patients with breast cancer were analyzed separately from patients with gynecologic cancer. RESULTS: Overall adherence rates ranged from 87% to 94%, and there were no significant differences between the TPN group and the EUC group. Among women with breast cancer, 90% of the EUC group and 88% of the TPN group completed chemotherapy (14% of the EUC group and 26% of the TPN group delayed the completion of chemotherapy), 2% of the EUC group and 4% of the TPN group failed to complete chemotherapy, and 8% of the EUC group and 7% of the TPN group refused chemotherapy. Radiation treatment adherence was similar between the groups: Ninety percent of patients completed radiation (40% of the EUC group and 42% of the TPN group delayed the completion of radiation); in both groups, 2% failed to complete radiation, and 8% refused radiation. Among gynecologic patients, 87% of the EUC group and 94% of the TPN group completed chemotherapy (41% of the EUC group and 31% of the TPN group completed it with delays), 7% of the EUC group and 6% of the TPN group failed to complete chemotherapy, 6% of the EUC refused chemotherapy, 87% of the EUC group and 84% of the TPN group completed radiation (51% of the EUC group and 42% of the TPN with delays), 5% of the EUC group and 8% of the TPN group failed to complete radiation, and 8% of the EUC group and 5% of the TPN group refused radiation. CONCLUSIONS: Treatment adherence across randomized groups was notably higher than reported in previous studies, suggesting that active telephone patient navigation or written resource informational materials may facilitate adherence among low‐income, predominantly Hispanic women. Adherence also may have be facilitated by federal‐state breast and cervical cancer treatment funding. Cancer 2009. © 2009 American Cancer Society.
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From Behavioral interventions to enhance adherence to hormone therapy in breast cancer survivors: a systematic literature review (2016) · cites this paper as [20]
Publication bias tends to occur when negative findings are not published.
“Since publication bias tends to occur when negative findings are not published,20 if there were unpublished papers, they would probably confirm the limited efficacy of the interventions to improve adjuvant hormonal therapy adherence rates.”
From Behavioral interventions to enhance adherence to hormone therapy in breast cancer survivors: a systematic literature review (2016) · cites this paper as [20]
It is not possible to assure that all behavioral adjuvant hormonal therapy interventions were retrieved due to limitations of MeSH terms and publication bias.
“As in any systematic literature review, it is not possible to assure that all the behavioral adjuvant hormonal therapy interventions were retrieved due to the limitations of using MeSH terms and publication bias.19, 20”
From Behavioral interventions to enhance adherence to hormone therapy in breast cancer survivors: a systematic literature review (2016) · cites this paper as [20]
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- Authors
- Ell, K., Vourlekis, B., Xie, B., Nedjat‐Haiem, F. R., Lee, P., Muderspach, L., Russell, C., & Palinkas, L. A.
- Affiliations
- University of Southern California (US)
- University of Maryland, Baltimore (US)
- ORCID
- Venue
- Cancer
- Publisher
- Wiley
- Published
- 2009-06-23
- Volume
- 115
- Issue
- 19
- Pages
- 4606-4615
- ISSN
- 0008-543X (ISSN-L)
- 1097-0142
- PMC
- PMC2749894
- OpenAlex
- W2047684438
- Cited by
- 132
- References
- 62
- Citations by year
- 2026: 1 · 2025: 5 · 2024: 5 · 2023: 7 · 2022: 8 · 2021: 8 · 2020: 7 · 2019: 10 · 2018: 7 · 2017: 9 · 2016: 10 · 2015: 7 · 2014: 9 · 2013: 14 · 2012: 10
- FWCI
- 4.17
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Cancer (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Cancer Institute (R01 CA94827, R01CA094827)
- Topics
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Women's cancer prevention and management
- Keywords
- patient navigation, low-income women, Hispanic women, breast cancer, gynecologic cancer, adjuvant therapy, chemotherapy completion, follow-up care
- MeSH terms
- Breast Neoplasms, Combined Modality Therapy, Female, Genital Neoplasms, Female, Hispanic or Latino, Humans, Middle Aged, Patient Compliance, Patient Education as Topic, Poverty, Quality of Life, Survival Analysis
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