Breast cancer oral anti-cancer medication adherence: a systematic review of psychosocial motivators and barriers
Abstract
Purpose In the past decade, there has been an increase in the development and use of oral anti-cancer medications (OAMs), especially for breast cancer-the most prevalent cancer in women. However, adherence rates for OAMs are often suboptimal, leading to lower survival rate, increased risk of recurrence, and higher healthcare costs. Our goal was to identify potentially modifiable psychosocial facilitators and barriers that may be targeted to increase OAM adherence for breast cancer patients.Methods We systematically searched PubMed for studies published in the U.S. by June 15, 2016 that addressed the following: (1) OAMs for breast cancer; (2) medication adherence; and (3) at least one psychosocial aspect of adherence.Results Of the 1752 papers screened, 21 articles were included and analyzed. The most commonly reported motivators for adherence are patient-provider relationships (n = 11 studied, 82% reported significant association) and positive views and beliefs of medication (n = 9 studied, 89% reported significant association). We also identified consistent evidence of the impact of depression and emotions, perception of illness, concern of side effects, self-efficacy in medication management and decision making, knowledge of medication, and social support on OAM adherence.Conclusions Compared to traditional demographic, system, and clinical-related factors that have been well documented in the literature but are not easily changed, these cognitive, psychological, and interpersonal factors are more amendable via intervention and therefore could generate greater benefit in improving patient compliance and health outcomes. As OAMs shift treatment administration responsibility onto patients, continuous provider communication and education on illness and regimen are the keys to supporting patients' medication behavior.
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These factors can have negative consequences for the disease course, including increased frequency and duration of hospital stays, lower adherence to treatment recommendations, difficulties coping, reduced quality of life, and increased mortality.
“These factors can have negative consequences for the disease course, including an increase in the frequency and duration of hospital stays, lower adherence to treatment recommendations, difficulties in coping with the disease, reduced quality of life and an increase in mortality [9–14].”
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- Authors
- Lin, C., Clark, R., Tu, P., Bosworth, H. B., & Zullig, L. L.
- Affiliations
- Duke University (US)
- Corresponding author
- Lin, Cheryl
- Venue
- Breast Cancer Research and Treatment
- Published
- 2017-06-01
- Volume
- 165
- Issue
- 2
- Pages
- 247-260
- ISSN
- 0167-6806 (ISSN-L)
- 1573-7217
- OpenAlex
- W2621337730
- Cited by
- 160
- References
- 55
- Citations by year
- 2026: 15 · 2025: 14 · 2024: 20 · 2023: 22 · 2022: 32 · 2021: 23 · 2020: 14 · 2019: 12 · 2018: 7 · 2017: 1
- FWCI
- 1.55
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Breast Cancer Research and Treatment (publishedVersion)
- PubMed (publishedVersion)
- Funders
- VA Research Career Scientist Award (RCS 08-027)
- VA Health Services Research and Development (HSR&D) Career Development Award (CDA 13-025)
- Duke University Bass Connections
- Topics
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
- Keywords
- breast cancer, medication adherence, psychosocial factors, patient-provider relationship, medication beliefs, depression, adverse effects, self-efficacy, social support, patient education, treatment adherence interventions
- MeSH terms
- Administration, Oral, Antineoplastic Agents, Breast Neoplasms, Female, Humans, Physician-Patient Relations, Quality of Life, Stress, Psychological, Medication Adherence
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