Endocrine therapy for breast cancer: assessing an array of women’s treatment experiences and perceptions, their perceived self-efficacy and nonadherence
Open accessAbstract
Background Although adjuvant endocrine therapy effectively prevents breast cancer recurrence, nonadherence rates are substantial. We therefore examined associations of women's experiences and perceptions regarding the efficacy, side effects, and practical problems of endocrine therapy with nonadherence. Furthermore, we examined whether women's perceived self-efficacy moderated these associations.Patients and methods Two hundred forty-one breast cancer patients participated. Using the electronic Tailored Medicine Inventory, which enables skipping of irrelevant items, experiences and perceptions were assessed in a comprehensive yet feasible manner. Adherence was assessed according to self-report and evaluated for agreement with adherence estimated from pharmacy refill data.Results A substantial number of women doubted the efficacy of endocrine therapy, were worried about and/or had experienced hot flushes, loss of libido, joint ache, and/or practical problems with regard to information, intake, and packaging. Experience of practical problems (odds ratio [OR], 2.4; 95% confidence interval [CI], 1.0-5.8) and perceived self-efficacy with regard to medicine intake (OR, 0.5; 95% CI, 0.4-0.7) were associated with unintentional nonadherence. Number of side effects experienced (OR, 1.2; 95% CI, 1.05-1.4) and perceived self-efficacy with regard to learning about medication (OR, 0.6; 95% CI, 0.4-0.96) were associated with intentional nonadherence. Perceived self-efficacy did not moderate associations between women's treatment experiences and perceptions and nonadherence.Conclusion Endocrine therapy is challenging for many women. Targeting women's specific experiences and perceptions and improving their perceived self-efficacy is likely to decrease intentional and unintentional nonadherence.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Unintentional non-adherence, such as forgetting, may be more common than intentionally missing doses.
“Unintentional non-adherence, such as forgetting, may be more common than intentionally missing doses.14–16”
Cites
1 retracted
Retracted: Predictive Validity of a Medication Adherence Measure in an Outpatient Setting
Morisky, D. E., Ang, A., Krousel‐Wood, M., & Ward, H. J. (2008) · The Journal of Clinical Hypertension · doi:10.1111/j.1751-7176.2008.07572.x · Cited by 2,877 · see citing works
RetractedOsterberg, L., & Blaschke, T. (2005) · New England Journal of Medicine · doi:10.1056/nejmra050100 · Cited by 7,974 · see citing works
Negative Self-Efficacy and Goal Effects Revisited
Bandura, A., & Locke, E. A. (2003) · Journal of Applied Psychology · doi:10.1037/0021-9010.88.1.87 · Cited by 2,813 · see citing works
Horne, R., Weinman, J. A., & Hankins, M. C. (1999) · Psychology and Health · doi:10.1080/08870449908407311 · Cited by 2,383 · see citing works
Sirey, J. A., Bruce, M. L., Alexopoulos, G. S., Perlick, D. A., Friedman, S. J., & Meyers, B. S. (2001) · Psychiatric Services · doi:10.1176/appi.ps.52.12.1615 · Cited by 796 · see citing works
Adherence to Initial Adjuvant Anastrozole Therapy Among Women With Early-Stage Breast Cancer
Partridge, A. H., LaFountain, A., Mayer, E. L., Taylor, B. S., Winer, E. P., & Asnis-Alibozek, A. G. (2008) · Journal of Clinical Oncology · doi:10.1200/jco.2007.11.5451 · Cited by 483 · see citing works
McCowan, C., Shearer, J., Donnan, P. T., Dewar, J. A., Crilly, M., Thompson, A. M., & Fahey, T. P. (2008) · British Journal of Cancer · doi:10.1038/sj.bjc.6604758 · Cited by 343 · see citing works
Adherence to tamoxifen over the five-year course
Lash, T. L., Fox, M. P., Westrup, J., Fink, A. K., & Silliman, R. A. (2006) · Breast Cancer Research and Treatment · doi:10.1007/s10549-006-9193-0 · Cited by 321 · see citing works
Adjuvant Tamoxifen: Predictors of Use, Side Effects, and Discontinuation in Older Women
Demissie, S., Silliman, R. A., & Lash, T. L. (2001) · Journal of Clinical Oncology · doi:10.1200/jco.2001.19.2.322 · Cited by 301 · see citing works
Intentional and non-intentional non-adherence to medication amongst breast cancer patients
Atkins, L., & Fallowfield, L. (2006) · European Journal of Cancer · doi:10.1016/j.ejca.2006.03.004 · Cited by 300 · see citing works
Fink, A. K., Gurwitz, J. H., Rakowski, W., Guadagnoli, E., & Silliman, R. A. (2004) · Journal of Clinical Oncology · doi:10.1200/jco.2004.11.064 · Cited by 282 · see citing works
Schilder, C. M. T., Seynaeve, C., Beex, L. V. A. M., Boogerd, W. J., Linn, S. C., Gundy, C. M., Huizenga, H. M., Nortier, J. W. R., van de Velde, C. J., van Dam, F. S. A. M., et al. (2010) · Journal of Clinical Oncology · doi:10.1200/jco.2008.21.3553 · Cited by 270 · see citing works
Adherence to adjuvant endocrine therapy in postmenopausal women with breast cancer
Ziller, V., Kalder, M., Albert, U., Holzhauer, W., Ziller, M., Wagner, U. A. G., & Hadji, P. (2009) · Annals of Oncology · doi:10.1093/annonc/mdn646 · Cited by 263 · see citing works
Adherence to endocrine therapy for breast cancer
Chlebowski, R. T., & Geller, M. L. (2006) · Oncology · doi:10.1159/000100444 · Cited by 251 · see citing works
Adherence beliefs among breast cancer patients taking tamoxifen
Grunfeld, E. A., Hunter, M. S., Sikka, P., & Mittal, S. (2004) · Patient Education and Counseling · doi:10.1016/j.pec.2004.10.005 · Cited by 245 · see citing works
Kripalani, S. B., Gatti, M. E., & Jacobson, T. A. (2010) · Patient Education and Counseling · doi:10.1016/j.pec.2010.04.030 · Cited by 141 · see citing works
Non-adherence to statin therapy: a major challenge for preventive cardiology
Bates, T., Connaughton, V., & Watts, G. F. (2009) · Expert Opinion on Pharmacotherapy · doi:10.1517/14656560903376186 · Cited by 136 · see citing works
Measuring patients’ self-efficacy in understanding and using prescription medication
Cameron, K. A., Ross, E. L., Clayman, M. L., Bergeron, A. R., Federman, A. D., Bailey, S. C., Davis, T. C., & Wolf, M. S. (2010) · Patient Education and Counseling · doi:10.1016/j.pec.2010.06.029 · Cited by 103 · see citing works
Adjuvant Tamoxifen Prescription in Women 65 Years and Older With Primary Breast Cancer
Silliman, R. A., Guadagnoli, E., Rakowski, W., Landrum, M. B., Lash, T. L., Wolf, R., Fink, A. K., Ganz, P. A., Gurwitz, J. H., Borbas, C., et al. (2002) · Journal of Clinical Oncology · doi:10.1200/jco.2002.08.137 · Cited by 92 · see citing works
Güth, U., Huang, D. J., Schötzau, A., Zanetti‐Dällenbach, R., Holzgreve, W., Bitzer, J., & Wight, E. (2008) · British Journal of Cancer · doi:10.1038/sj.bjc.6604525 · Cited by 56 · see citing works
van Geffen, E. C. G., van der Wal, S. W., van Hulten, R., de Groot, M., Egberts, T. C. G., & Heerdink, E. R. (2007) · European Journal of Clinical Pharmacology · doi:10.1007/s00228-007-0375-4 · Cited by 55 · see citing works
Wouters, H., van Geffen, E. C. G., Baas-Thijssen, M. C. M., Krol-Warmerdam, E. M., Stiggelbout, A. M., Belitser, S. V., Bouvy, M. L., & van Dijk, L. (2013) · The Breast · doi:10.1016/j.breast.2013.05.005 · Cited by 26 · see citing works
Beliefs About Asthma Medications: Patients Perceive Both Benefits and Drawbacks
Choi, T. N., Westermann, H., Sayles, W., Mancuso, C. A., & Charlson, M. E. (2008) · Journal of Asthma · doi:10.1080/02770900801971834 · Cited by 25 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Moon, Z., Moss-Morris, R. E., Hunter, M. S., Carlisle, S., & Hughes, L. D. (2017) · Patient Preference and Adherence · doi:10.2147/ppa.s126651 · Cited by 147 · see citing works
Lambert, L. K., Balneaves, L. G., Howard, A. F., & Gotay, C. C. (2017) · Breast Cancer Research and Treatment · doi:10.1007/s10549-017-4561-5 · Cited by 126 · see citing works
Understanding tamoxifen adherence in women with breast cancer: A qualitative study
Moon, Z., Moss‐Morris, R., Hunter, M. S., & Hughes, L. D. (2017) · British Journal of Health Psychology · doi:10.1111/bjhp.12266 · Cited by 112 · see citing works
Toivonen, K., Williamson, T., Carlson, L., Walker, L., & Campbell, T. (2020) · Cancers · doi:10.3390/cancers13010107 · Cited by 77 · see citing works
Finitsis, D. J., Vose, B. A., Mahalak, J. G., & Salner, A. L. (2019) · Psycho-Oncology · doi:10.1002/pon.4959 · Cited by 68 · see citing works
Engelhardt, E. G., Pieterse, A. H., van der Hout, A., de Haes, J. C. J. M., Kroep, J. R., van Ufford-Mannesse, P. Q., Portielje, J. E. A., Smets, E. M. A., & Stiggelbout, A. M. (2016) · European Journal of Cancer · doi:10.1016/j.ejca.2016.07.011 · Cited by 76 · see citing works
Acceptability and feasibility of a self-management intervention for women prescribed tamoxifen
Moon, Z., Moss-Morris, R. E., Hunter, M. S., Goodliffe, S., & Hughes, L. D. (2019) · Health Education Journal · doi:10.1177/0017896919853856 · Cited by 66 · see citing works
Brett, J., Boulton, M. G., Fenlon, D., Hulbert-Williams, N., Walter, F. M., Donnelly, P., Lavery, B. A., Morgan, A. A., Morris, C., & Watson, E. K. (2018) · Patient Preference and Adherence · doi:10.2147/ppa.s145784 · Cited by 63 · see citing works
Wouters, H., van Dijk, L., Geers, H. C. J., Winters, N. A., van Geffen, E. C. G., Stiggelbout, A. M., & Bouvy, M. L. (2016) · PLoS ONE · doi:10.1371/journal.pone.0146272 · Cited by 54 · see citing works
Farias, A. J., Ornelas, I. J., Hohl, S. D., Zeliadt, S. B., Hansen, R. N., Li, C. I., & Thompson, B. (2016) · Supportive Care in Cancer · doi:10.1007/s00520-016-3389-6 · Cited by 49 · see citing works
Fleming, L., Agnew, S., Peddie, N., Crawford, M., Dixon, D. L., & Macpherson, I. R. (2022) · The Breast · doi:10.1016/j.breast.2022.04.010 · Cited by 50 · see citing works
How Can We Best Respect Patient Autonomy in Breast Cancer Treatment Decisions?
Martinez, K. A., Kurian, A. W., Hawley, S. T., & Jagsi, R. (2015) · Breast Cancer Management · doi:10.2217/bmt.14.47 · Cited by 45 · see citing works
Timmers, L., Boons, C. C. L. M., Verbrugghe, M., van den Bemt, B. J. F., Hecke, A. V., & Hugtenburg, J. G. (2017) · BMC Cancer · doi:10.1186/s12885-017-3110-2 · Cited by 44 · see citing works
Moon, Z., Moss-Morris, R. E., Hunter, M. S., & Hughes, L. D. (2017) · British Journal of Health Psychology · doi:10.1111/bjhp.12274 · Cited by 43 · see citing works
Park, H. R., Kang, H. S., Kim, S. H., & Singh‐Carlson, S. (2021) · Cancer Nursing · doi:10.1097/ncc.0000000000001030 · Cited by 41 · see citing works
Adherence to Adjuvant Tamoxifen in Mexican Young Women with Breast Cancer
Martínez-Cannon, B. A., Castro‐Sánchez, A., Barragán-Carrillo, R., Pacheco, S. D. L. R., Platas, A., Fonseca, A., Vega, Y., Bojoquez-Velazquez, K., Bargalló‐Rocha, E., Mohar, A., et al. (2021) · Patient Preference and Adherence · doi:10.2147/ppa.s296747 · Cited by 30 · see citing works
Green, S. M. C., French, D., Graham, C. D., Hall, L., Rousseau, N. S., Foy, R., Clark, J., Parbutt, C., Raine, E., Gardner, B., et al. (2022) · BMC Health Services Research · doi:10.1186/s12913-022-08243-4 · Cited by 31 · see citing works
When patients’ invisible work becomes visible: non‐adherence and the routine task of pill‐taking
Huyard, C., Haak, H. R., Derijks, L. J. J., & Lieverse, L. A. G. (2018) · Sociology of Health & Illness · doi:10.1111/1467-9566.12806 · Cited by 27 · see citing works
Chalela, P., Muñoz, E., Inupakutika, D., Kaghyan, S., Akopian, D., Kaklamani, V., Lathrop, K. I., & Ramírez, A. G. (2018) · Contemporary Clinical Trials Communications · doi:10.1016/j.conctc.2018.10.001 · Cited by 26 · see citing works
Salgado, T. M., Davis, E. J., Farris, K. B., Fawaz, S., Batra, P., & Henry, N. L. (2017) · Breast Cancer Research and Treatment · doi:10.1007/s10549-017-4177-9 · Cited by 24 · see citing works
Applying the theory of planned behavior to examine adjuvant endocrine therapy adherence intentions
Hurtado‐de‐Mendoza, A., Carrera, P., Parrott, W. G., Gómez‐Trillos, S., Perera, R. A., & Sheppard, V. B. (2018) · Psycho-Oncology · doi:10.1002/pon.4931 · Cited by 22 · see citing works
Moon, Z., Moss-Morris, R. E., Hunter, M. S., & Hughes, L. D. (2020) · Supportive Care in Cancer · doi:10.1007/s00520-020-05850-x · Cited by 22 · see citing works
Smith, S. G., Green, S. M. C., Ellison, R., Foy, R., Graham, C. D., Mason, E., French, D. P., Hall, L. H., Wilkes, H., McNaught, E., et al. (2023) · BMJ Open · doi:10.1136/bmjopen-2022-069971 · Cited by 20 · see citing works
“It is not just any pill”—Women’s experiences of endocrine therapy after breast cancer surgery
Karlsson, S. A., Wallengren, C., Bagge, R. O., & Henoch, I. (2019) · European Journal of Cancer Care · doi:10.1111/ecc.13009 · Cited by 17 · see citing works
Relationships between determinants of adjuvant endocrine therapy adherence in breast cancer
Lee, J. Y., & Min, Y. H. (2018) · BMC Women s Health · doi:10.1186/s12905-018-0522-3 · Cited by 17 · see citing works
Yang, S., Park, S. W., Bae, S. J., Ahn, S. G., Jeong, J., & Park, K. (2023) · Journal of Breast Cancer · doi:10.4048/jbc.2023.26.e22 · Cited by 15 · see citing works
Farias, A. J., Wu, W.-H., & Du, X. L. (2018) · Medical Oncology · doi:10.1007/s12032-018-1168-6 · Cited by 13 · see citing works
Exploring adherence in patients with advanced breast cancer: focus on CDK4/6 inhibitors
Baković, M., Bago, M., Benić, L., Krajinović, M., Silovski, T., Plavetić, N. D., Turković, L., Sertić, M., & Hadžiabdić, M. O. (2023) · Acta Pharmaceutica · doi:10.2478/acph-2023-0045 · Cited by 9 · see citing works
Rassy, E., Bardet, A., Bougacha, O., Gantzer, L., Lekens, B., Delaloge, S., André, F., Michiels, S., & Pistilli, B. (2022) · JAMA Network Open · doi:10.1001/jamanetworkopen.2022.44849 · Cited by 8 · see citing works
Implicit persuasion in medical decision-making
Engelhardt, E. G., Pieterse, A. H., & Stiggelbout, A. M. (2018) · Journal of Argumentation in Context · doi:10.1075/jaic.18032.eng · Cited by 8 · see citing works
Dibble, K. E., Baumgartner, R., Boone, S. D., Baumgartner, K. B., & Connor, A. E. (2023) · Breast Cancer Research and Treatment · doi:10.1007/s10549-023-06900-8 · Cited by 6 · see citing works
Beisel, C., Poretta, T., Sheppard, V. B., de Mendoza, A. H., Sipsma, H. L., Fuqua, E., Stwalley, B. D., Salvatore, A., & Yang, M. (2022) · Advances in Therapy · doi:10.1007/s12325-022-02221-2 · Cited by 6 · see citing works
Green, S. M. C., Smith, S. G., Collins, L. M., & Strayhorn, J. C. (2024) · Translational Behavioral Medicine · doi:10.1093/tbm/ibae029 · Cited by 5 · see citing works
Larson, K. E., Grobmyer, S., Karafa, M., & Pratt, D. A. (2018) · Cancer Treatment and Research Communications · doi:10.1016/j.ctarc.2018.04.002 · Cited by 4 · see citing works
Lesur, A., Dalenc, F., & Beguignot, M. (2019) · Bulletin du Cancer · doi:10.1016/s0007-4551(20)30045-x · Cited by 4 · see citing works
Karlsson, S. A., Henoch, I., Bagge, R. O., & Wallengren, C. (2022) · Evaluation and Program Planning · doi:10.1016/j.evalprogplan.2022.102071 · Cited by 4 · see citing works
Wang, L., Tao, W. Y., Liu, J., Peng, S., Chen, J., Hu, M., & Li, X. (2023) · BMJ Open · doi:10.1136/bmjopen-2023-073915 · Cited by 3 · see citing works
McCall, M. K., Sereika, S. M., Snader, S., Lavanchy, A., Rosenzweig, M. Q., Conley, Y. P., Beumer, J. H., & Bender, C. M. (2022) · Supportive Care in Cancer · doi:10.1007/s00520-022-07326-6 · Cited by 2 · see citing works
Mesquita, B., Bártolo, A., Remondes‐Costa, S., Carreiro, J., & Cardoso, S. (2026) · Journal of Clinical Medicine · doi:10.3390/jcm15020858 · Cited by 1 · see citing works
Vazquez, O., Mendoza-Contreras, L. A., Penedo, F. J., Alcaraz, R. B., & Rocha, E. B. (2022) · Psicooncología · doi:10.5209/psic.80802 · Cited by 1 · see citing works
Budaycı, Ö., & Özkan, S. (2025) · Pamukkale Medical Journal · doi:10.31362/patd.1621040
Green, S. M. C., French, D., Graham, C. D., Hall, L., Rousseau, N., Foy, R., Clark, J., Parbutt, C., Raine, E., Gardner, B., et al. (2022) · Figshare · doi:10.6084/m9.figshare.20619870
Green, S. M. C., French, D., Graham, C. D., Hall, L., Rousseau, N., Foy, R., Clark, J., Parbutt, C., Raine, E., Gardner, B., et al. (2022) · Figshare · doi:10.6084/m9.figshare.20619867
Green, S. M. C., French, D., Graham, C. D., Hall, L., Rousseau, N., Foy, R., Clark, J., Parbutt, C., Raine, E., Gardner, B., et al. (2022) · Figshare · doi:10.6084/m9.figshare.20619876
Queiroz, A. P. M. O., de Aguiar, V. S., Borges, L. M., & dos Santos, J. R. B. (2026) · Psicologia e Saúde em Debate · doi:10.22289/2446-922x.v12a1a75
Lin, K., & Lin, K. (2026) · Journal of Oncology Pharmacy Practice · doi:10.1177/10781552261487600
- Authors
- Wouters, H., Stiggelbout, A. M., Bouvy, M. L., Maatman, G. A., Van Geffen, E. C. G., Vree, R., Nortier, J. W., & Van Dijk, L.
- Affiliations
- Utrecht University (NL)
- Leiden University Medical Center (NL)
- Corresponding author
- Wouters, Hans
- Venue
- Clinical Breast Cancer
- Publisher
- Elsevier BV
- Published
- 2014-12
- Volume
- 14
- Issue
- 6
- Pages
- 460-467.e2
- ISSN
- 1526-8209 (ISSN-L)
- OpenAlex
- W2064840696
- Cited by
- 46
- References
- 24
- Citations by year
- 2026: 3 · 2025: 1 · 2024: 1 · 2023: 5 · 2022: 10 · 2021: 2 · 2020: 2 · 2019: 3 · 2018: 9 · 2017: 6 · 2016: 3 · 2015: 1
- FWCI
- 3.42
- Type
- journal article
- Language
- en
- Open access
- green
- www.nivel.nl
- Licence
- Locations
- Clinical Breast Cancer (publishedVersion)
- PubMed (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Leiden Repository (Leiden University) (submittedVersion)
- Utrecht University Repository (Utrecht University) (submittedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion)
- Funders
- Netherlands Organization for Health Research and Development (ZonMw) (152002028)
- Topics
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Breast Cancer Treatment Studies
- Keywords
- breast cancer, endocrine therapy, medication non-adherence, self-efficacy, adverse effects, hot flashes, adjuvant therapy, patient-reported outcomes
- MeSH terms
- Breast Neoplasms, Female, Follow-Up Studies, Humans, Health Knowledge, Attitudes, Practice, Middle Aged, Perception, Prognosis, Antineoplastic Agents, Hormonal, Self Efficacy, Medication Adherence
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
