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Cited by 79Medication Adherence and ComplianceCancer survivorship and careWomen's cancer prevention and management

Behavioral interventions to enhance adherence to hormone therapy in breast cancer survivors: a systematic literature review

Open access
Hurtado-de-Mendoza, Alejandra, Cabling, Mark L., Lobo, Tania, Dash, Chiranjeev, Sheppard, Vanessa B.·2016·Clinical Breast Cancer
DOI 10.1016/j.clbc.2016.03.006PMC PMC4969158
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Abstract

Adjuvant hormone therapy contributes to reductions in recurrence and mortality for women with hormone receptor-positive breast cancer. However, adherence to hormone therapy is suboptimal. This is the first systematic literature review examining interventions aimed at improving hormone therapy adherence. Researchers followed the PRISMA guidelines. PubMed-Medline, CINAHL, PsychInfo, Ovid-Medline, and EMBASE were searched for behavioral interventions that aimed to enhance adherence to adjuvant hormone therapy in breast cancer survivors. A total of 376 articles were screened for eligibility. Five articles met the study criteria. All interventions presented adherence outcomes after 1-year follow-up. None significantly enhanced adherence compared to the usual care in the primary analysis (odds ratios ranged from 1.03 to 2.06 for adherence and from 1.11 to 1.18 for persistence). All studies targeted patients, and only 3 studies included postmenopausal breast cancer patients. Three tested the same intervention consisting of educational materials. Only one was conducted in the United States. Only one reported participants' ethnicity. Overall, it was unclear whether the studies contained bias. The use of different terminology and operationalization of adherence made comparisons challenging. Interventions to improve adherence to adjuvant hormone therapy in US breast cancer populations that include survivors who are ethnically diverse, premenopausal, and receiving tamoxifen therapy are necessary to inform future interventions. Adoption of consistent adherence definitions/measurements will provide a clearer framework to consolidate aggregate findings. Given the limited efficacy of tested interventions, it is important to engage oncologists and researchers to develop approaches that target different components associated with hormone therapy adherence, such as doctor-patient communication or social support.

Integrity signals

Registry

Crossref · 10.1016/j.clbc.2016.03.006

Cites

56 of 56 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 82 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    80% (4/5) of papers included only patients taking aromatase inhibitors.

    “80% (n=4) of papers included only breast cancer patients who were taking Aromatase Inhibitors (AIs) (three of them focused only on post-menopausal survivors).”
    Quote in the paperNot a substantial claim
  • Findingown data

    Three studies tested the same intervention consisting of educational materials.

    “Three tested the same intervention consisting of educational materials.”
    • Also stated in: § Studies · plain
      “In relation to the interventions, three of the studies tested the German-based PACT study intervention but in different contexts.14, 24, 25”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [14] Font, 2012, Prescription refill, patient self-report and physician report in assessing adherence to oral endocrine therapy in early breast cancer patients: a retrospective cohort study in Catalonia, Spain, Br J Cancer source

      Not checked in the free run.

    • cites [24] Osterberg, 2005, Adherence to medication, N Engl J Med source

      Not checked in the free run.

    • cites [25] Cramer, 2008, Medication compliance and persistence: terminology and definitions, Value Health source

      Not checked in the free run.

    • Rests on an assumption: The PACT intervention tested in the three studies was sufficiently similar across contexts to be treated as the same intervention.
  • Findingown data

    All interventions targeted patients.

    “All targeted patients and three only included post-menopausal breast cancer patients.”
    • Also stated in: § Studies · plain
      “All interventions were targeted towards patients (100%; n=5).”
    Quote in the paperNot a substantial claim
  • Findingown data

    Three studies included only postmenopausal breast cancer patients.

    “All targeted patients and three only included post-menopausal breast cancer patients.”
    • Also stated in: § Studies · plain
      “80% (n=4) of papers included only breast cancer patients who were taking Aromatase Inhibitors (AIs) (three of them focused only on post-menopausal survivors).”
    Quote in the paperNot a substantial claim
  • Findingown data

    Five articles met the eligibility criteria.

    “Five articles met criteria.”
    • Also stated in: § Studies · plain
      “Five papers met the eligibility criteria (see Figure 1 for additional details).”
    Quote in the paperSubstantial claim
  • Classified as probably not a substantial claim. 14
  • May combine two claims. 23
  • The quote only partly states this claim. 1

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Only one study reported participants' ethnicity.

    “Only one reported participants' ethnicity.”
    • Also stated in: § Studies · plain
      “Only one study was conducted in the US28 and it was the only one that reported participants' ethnicity.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    One paper included patients taking either aromatase inhibitors or tamoxifen, and none were restricted to tamoxifen only.

    “There was only one paper (20%) that included patients who were taking either AIs or tamoxifen and none of the studies were restricted to survivors taking tamoxifen only.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The odds ratios for adherence in primary analyses ranged from 1.03 to 2.06, and for persistence from 1.11 to 1.18.

    “(OR ranged from 1.03 to 2.06 for adherence and from 1.11 – 1.18 for persistence).”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The odds ratios calculated across studies with differing adherence definitions and measures are comparable enough to support the conclusion of no significant effect.

  • May combine two claims.

    Findingcitation

    All interventions were patient-focused and included educational and reminder components.

    “All the interventions were patient-focused (rather than physician-focused or patient-provider communication focused) and comprised of an educational and a reminder component.14, 24-26, 28”
    Quote in the paperSubstantial claim0 of 5 sources checked
    • cites [14] Font, 2012, Prescription refill, patient self-report and physician report in assessing adherence to oral endocrine therapy in early breast cancer patients: a retrospective cohort study in Catalonia, Spain, Br J Cancer source

      Not checked in the free run.

    • cites [24] Osterberg, 2005, Adherence to medication, N Engl J Med source

      Not checked in the free run.

    • cites [25] Cramer, 2008, Medication compliance and persistence: terminology and definitions, Value Health source

      Not checked in the free run.

    • cites [26] Ruddy, 2009, Patient adherence and persistence with oral anticancer treatment, CA Cancer J Clin

      Not checked in the free run.

    • cites [28] Partridge, 2003, Nonadherence to adjuvant tamoxifen therapy in women with primary breast cancer, J Clin Oncol source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    Ziller and colleagues' intervention was the only one with higher odds of enhancing adherence and found a difference between intervention arms and usual care in pooled analysis.

    “Echoing this, Ziller and colleagues' (2013)26 intervention, which included personalized motivational letters and motivational interviewing calls, was the only one with higher odds of enhancing adherence and that found a difference between the two intervention arms and the usual care arm in the pooled analysis.26”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [26] Ruddy, 2009, Patient adherence and persistence with oral anticancer treatment, CA Cancer J Clin

      Not checked in the free run.

  • May combine two claims.

    Findingnone given

    Adherence rates were generally high at year one in most studies, ranging from 81% to 96%, except in Ziller and colleagues' study.

    “Adherence rates were generally high at year one in most studies, except in Ziller and colleagues', ranging from 81% to 96%.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Adherence was measured by self-report in one paper, pharmacy records in two, and a combination in two.

    “Adherence was measured by self-report in one paper (20%), by pharmacy records in two papers (40%), or by a combination of both in two papers (40%).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    In IMPAACT, among 44 patients who obtained tamoxifen or anastrozole, 59% were adherent and there was no significant difference in hormonal therapy adherence between arms.

    “From the 44 patients that obtained tamoxifen or anastrozole, 59% were adherent and there was no significant difference in hormonal therapy adherence between the two arms.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [28] Partridge, 2003, Nonadherence to adjuvant tamoxifen therapy in women with primary breast cancer, J Clin Oncol source

      Not checked in the free run.

    • Rests on an assumption: The odds ratios calculated across studies with differing adherence definitions and measures are comparable enough to support the conclusion of no significant effect.

  • May combine two claims.

    Findingown data

    In CARIATIDE, the intervention had a significantly positive effect on overall adherence in Sweden/Finland (p=0.02) and a significantly negative effect in Austria/Switzerland (p=0.03).

    “However, there were some significant differences in specific countries, as intervention had a significantly positive impact on overall adherence in Sweden/Finland (p=0.02) and a significantly negative impact in Austria/Switzerland (p=0.03).”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The odds ratios calculated across studies with differing adherence definitions and measures are comparable enough to support the conclusion of no significant effect.

  • May combine two claims.

    Findingcitation

    The PACT study found no statistical differences between intervention and usual care in adherence (OR 1.03; CI 0.81-1.30) or persistence (OR 1.11; CI 0.95-1.29).

    “The primary endpoint analysis with 2,740 participants (usual care n=1,339; intervention n= 1,401) found no statistical differences between the intervention and usual care arms in adherence (OR: 1.03; CI: 0.81 – 1.30) and persistence (OR: 1.11; CI: 0.95 – 1.29).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [14] Font, 2012, Prescription refill, patient self-report and physician report in assessing adherence to oral endocrine therapy in early breast cancer patients: a retrospective cohort study in Catalonia, Spain, Br J Cancer source

      Not checked in the free run.

    • Rests on an assumption: The PACT intervention tested in the three studies was sufficiently similar across contexts to be treated as the same intervention.
    • Rests on an assumption: The odds ratios calculated across studies with differing adherence definitions and measures are comparable enough to support the conclusion of no significant effect.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    Some studies used the term 'compliance' instead of 'adherence'.

    “For instance, some studies used the term “compliance” instead of “adherence,”14, 24, 25 which is currently favored due to the paternalistic connotations associated with the term compliance.36”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [14] Font, 2012, Prescription refill, patient self-report and physician report in assessing adherence to oral endocrine therapy in early breast cancer patients: a retrospective cohort study in Catalonia, Spain, Br J Cancer source

      Not checked in the free run.

    • cites [24] Osterberg, 2005, Adherence to medication, N Engl J Med source

      Not checked in the free run.

    • cites [25] Cramer, 2008, Medication compliance and persistence: terminology and definitions, Value Health source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    The CARIATIDE study found no significant differences in adherence (OR 1.07; CI 0.89-1.30) or persistence (OR 1.18; CI 0.95-1.46) between intervention and usual care.

    “Findings from the final endpoint analyses (n=2,543) showed no significant differences in the odds of adherence (OR: 1.07; CI: 0.89 – 1.30) and persistence (OR: 1.18; CI: 0.95 – 1.46) between participants randomized to the intervention (n=1,268) and usual care arms (n=1,275).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [24] Osterberg, 2005, Adherence to medication, N Engl J Med source

      Not checked in the free run.

    • Rests on an assumption: The PACT intervention tested in the three studies was sufficiently similar across contexts to be treated as the same intervention.
    • Rests on an assumption: The odds ratios calculated across studies with differing adherence definitions and measures are comparable enough to support the conclusion of no significant effect.

  • May combine two claims.

    Findingcitation

    COMPAS found no significant differences between phone and usual care (OR 1.90; CI 0.90-4.03) or between letter and usual care (OR 2.06; CI 0.97-4.36) in primary analysis.

    “The primary analysis (n=171) found no statistically significant differences between the phone group and the usual care arms (OR 1.90; CI: 0.90-4.03) and between the letter group and usual care arms (OR: 2.06; CI: 0.97-4.36).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [26] Ruddy, 2009, Patient adherence and persistence with oral anticancer treatment, CA Cancer J Clin

      Not checked in the free run.

    • Rests on an assumption: The odds ratios calculated across studies with differing adherence definitions and measures are comparable enough to support the conclusion of no significant effect.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    Persistence was measured by case report forms in one paper, pharmacy records in one, and a combination in one.

    “Persistence was measured by case report forms (20%; n=1), pharmacy records (20%; n=1), or by a combination of both (20%; n=1).”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Study design and conductown data

    Odds ratios and 95% CIs comparing adherence and persistence between intervention and usual care were calculated from study results.

    “Odds ratios (OR) and its 95% CI comparing adherence and persistence with adjuvant hormonal therapy in the intervention compared to the usual care group were also calculated from study results and are presented in Tables 3 and 4.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    Two authors independently abstracted data, with additional reviewers resolving discrepancies.

    “AH and MC independently abstracted the data and two additional reviewers (CD and VS) resolved any discrepancies in data extraction.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Study design and conductnone given

    Only the primary adherence outcome was considered when multiple outcomes were reported.

    “In papers that had multiple adherence outcomes reported, only the primary outcome was considered for this review.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    Risk of bias was assessed with the Cochrane Collaboration's tool across six domains, independently by two authors.

    “Studies were assessed for risk of bias using the Cochrane Collaboration's tool27 that includes six potential biases: sequence generation; allocation concealment; blinding of participants, personnel, and outcome assessors; incomplete outcome data; selective outcome reporting; and other.”
    • Also stated in: § Risk of Bias Assessment · plain
      “Two authors (AH and MC) independently reviewed each bias and categorized them as “Yes,” “No,” or “Unclear”.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [27] Higgins, 2011, The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials, BMJ source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    The review searched PubMed-Medline, CINAHL, PsychInfo, Ovid-Medline, and EMBASE.

    “On October 9, 2014 two authors (AH, MC) searched PubMed-Medline, CINAHL, PsychInfo, Ovid-Medline, and EMBASE using the following key terms:”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    The review followed PRISMA guidelines.

    “Researchers followed the PRISMA guidelines.”
    • Also stated in: § Search Strategy · plain
      “The Preferred Reporting Items for Systematic Literature Reviews and Meta-Analysis (PRISMA)19, 20 was followed to conduct a systematic literature review about interventions to enhance adjuvant hormonal therapy adherence in breast cancer survivors.”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [19] Moher, 2009, Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement, J Clin Epidemiol source

      Not checked in the free run.

    • cites [20] Ell, 2009, Cancer treatment adherence among low-income women with breast or gynecologic cancer: a randomized controlled trial of patient navigation, Cancer source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    Two authors independently reviewed full texts of potentially eligible articles, with consensus and third-author resolution.

    “Then the full text of all articles categorized as “Maybe” and “Yes” were independently reviewed by AH and MC. Consensus was reached through discussion, and a third author (VS), was consulted to resolve any disagreements on article status (see Figure 1).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    Patient variables, social support, patient-provider communication, and healthcare factors such as cost are associated with adherence to systemic therapies in breast cancer survivors.

    “Patient variables (e.g., age), social support, patient-provider communication, and healthcare factors (e.g., cost) have been associated with breast cancer survivor adherence to systemic therapies.6, 16-18”
    Quote in the paperNot a substantial claim0 of 4 sources checked
    • cites [6] Murphy, 2012, Adherence to adjuvant hormonal therapy among breast cancer survivors in clinical practice: a systematic review, Breast Cancer Res Treat source

      Not checked in the free run.

    • cites [16] Kahn, 2007, Patient centered experiences in breast cancer: predicting long-term adherence to tamoxifen use, Med Care source

      Not checked in the free run.

    • cites [17] Neugut, 2012, Non-initiation of adjuvant hormonal therapy in women with hormone receptor–positive breast cancer: the Breast Cancer Quality of Care study (BQUAL), Breast Cancer Res Treat source

      Not checked in the free run.

    • cites [18] Liberati, 2009, The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration, J Clin Epidemiol source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Published adherence rates probably underestimate true adherence because doctors and patients overestimate adherence.

    “Moreover, given the challenges in measuring adherence behaviors11 and overestimation of adherence by doctors and patients, published rates are probably an underestimation of the true adherence rates.15”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [15] Cluze, 2012, Adjuvant endocrine therapy with tamoxifen in young women with breast cancer: determinants of interruptions vary over time, Ann Oncol source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    Two authors independently screened titles and abstracts, with consensus and third-author resolution.

    “In the first round of reviews, two authors (AH and MC) independently reviewed all the papers' titles and abstracts to check eligibility and categorized the papers as “Yes,” “No,” or “Maybe,” based on whether they met the inclusion criteria.”
    • Also stated in: § Inclusion and Exclusion Criteria · plain
      “Consensus was reached through discussion, and a third author (VS), was consulted to resolve any disagreements on article status (see Figure 1).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductown data

    Only Ziller and colleagues explicitly mentioned blinding of study staff, with no details on how blinding was achieved or whether participants were blinded.

    “Only one study, by Ziller and colleagues,26 explicitly mentioned blinding of the study staff (interviewers and analysts) although no details were presented regarding how blinding was achieved or whether participants were blinded (see Table 2A, only available as an online appendix, for more specific details about the bias analysis).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [26] Ruddy, 2009, Patient adherence and persistence with oral anticancer treatment, CA Cancer J Clin

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Some ethnic groups have the worst breast cancer mortality and morbidity outcomes.

    “Moreover, since some ethnic groups have the worst breast cancer mortality and morbidity outcomes,1 it is key to assure that interventions include diverse populations.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [1] Siegel, 2014, Cancer statistics, 2014, CA Cancer J Clin

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Frailty tends to be a concern in older women, while fertility issues uniquely impact younger premenopausal survivors.

    “Frailty tends to be a concern in older women37 while fertility issues uniquely impact younger premenopausal survivors.38”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [37] Howard-Anderson, 2012, Quality of life, fertility concerns, and behavioral health outcomes in younger breast cancer survivors: a systematic review, J Natl Cancer Inst source

      Not checked in the free run.

    • cites [38] Livaudais, 2012, Racial/ethnic differences in initiation of adjuvant hormonal therapy among women with hormone receptor–positive breast cancer, Breast Cancer Res Treat source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    An observational linguistic study found that doctors tend to give monologues with general information about adjuvant hormonal therapy and do not spend enough time discussing potential barriers and treatment impact with patients.

    “An observational linguistic study that analyzed doctor-patient communication around adjuvant hormonal therapy found that doctors tend to do monologues providing general information about adjuvant hormonal therapy, but do not spend enough time discussing with the patient about potential barriers and how the treatment may particularly impact them.41”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [41] Cella, 2008, Recognition and management of treatment-related side effects for breast cancer patients receiving adjuvant endocrine therapy, Breast Cancer Res Treat source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductnone given

    The authors included five search engines and adapted the search strategy for each.

    “However, the authors included five search engines and adapted the search strategy as necessary for each one.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    Social support is associated with higher adherence in a meta-analysis with various medical conditions and in several adjuvant hormonal therapy studies with breast cancer survivors.

    “Social support has also been associated with higher adherence in a meta-analysis with various medical conditions46 and in several adjuvant hormonal therapy studies with breast cancer survivors.16, 17, 47”
    Quote in the paperSubstantial claim0 of 4 sources checked
    • cites [16] Kahn, 2007, Patient centered experiences in breast cancer: predicting long-term adherence to tamoxifen use, Med Care source

      Not checked in the free run.

    • cites [17] Neugut, 2012, Non-initiation of adjuvant hormonal therapy in women with hormone receptor–positive breast cancer: the Breast Cancer Quality of Care study (BQUAL), Breast Cancer Res Treat source

      Not checked in the free run.

    • cites [46] Huiart, 2012, Early discontinuation of tamoxifen intake in younger women with breast cancer: is it time to rethink the way it is prescribed?, Eur J Cancer source

      Not checked in the free run.

    • cites [47] Misono, 2010, Healthcare information technology interventions to improve cardiovascular and diabetes medication adherence, Am J Manag Care

      Not checked in the free run.

  • The quote only partly states this claim.

    Interpretationreasoning

    If there were unpublished papers, they would probably confirm the limited efficacy of interventions to improve adherence.

    “if there were unpublished papers, they would probably confirm the limited efficacy of the interventions to improve adjuvant hormonal therapy adherence rates.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationreasoning

    Caution must be used in extrapolating these findings to other diseases or treatments.

    “Furthermore, since this review focused solely on studies regarding adjuvant hormonal therapy, caution must be used in extrapolating these findings to other types of diseases or treatments.”
    Quote in the paperNot a substantial claim
32 of 32

  • The paper relies on this without support.

    The PACT intervention tested in the three studies was sufficiently similar across contexts to be treated as the same intervention.

    “In relation to the interventions, three of the studies tested the German-based PACT study intervention but in different contexts.14, 24, 25”
    “Although the materials were translated, there is limited information about the type of adaptation conducted and the extent of how divergent the material became from the original PACT form.”

  • The paper relies on this without support.

    The odds ratios calculated across studies with differing adherence definitions and measures are comparable enough to support the conclusion of no significant effect.

    “Odds ratios (OR) and its 95% CI comparing adherence and persistence with adjuvant hormonal therapy in the intervention compared to the usual care group were also calculated from study results and are presented in Tables 3 and 4.”
    “The use of different terminology and operationalization of adherence made comparisons challenging.”
2 of 2

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?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Reminder components are attributed to all interventions

    Minor

    The results say three of five interventions incorporated reminders, while the discussion says all interventions had a reminder component.

  • Reported adherence odds-ratio range omits a study

    Minor

    The abstract gives 1.03 as the lowest adherence odds ratio, but the Yu study is reported with an adherence odds ratio of 1.01.

  • Direction of adherence-rate bias is reversed

    Minor

    The introduction cites overestimation of adherence by doctors and patients, then says published adherence rates probably underestimate true adherence. The stated reason points in the opposite direction.

3 of 3

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Authors
Hurtado-de-Mendoza, A., Cabling, M. L., Lobo, T., Dash, C., & Sheppard, V. B.
Affiliations
Georgetown University Medical Center (US)
Corresponding author
Cabling, Mark L.
ORCID
Venue
Clinical Breast Cancer
Publisher
Elsevier BV
Published
2016-08
Volume
16
Issue
4
Pages
247-255.e3
ISSN
1526-8209 (ISSN-L)
DOI
10.1016/j.clbc.2016.03.006
PMC
PMC4969158
OpenAlex
W2329997086
Cited by
79
References
56
Citations by year
2026: 6 · 2025: 7 · 2024: 5 · 2023: 17 · 2022: 17 · 2021: 7 · 2020: 4 · 2019: 6 · 2018: 7 · 2017: 3
FWCI
0.92
Type
journal article
Language
en
Open access
Licence
Locations
  • Clinical Breast Cancer (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Cancer Institute (R01CA154848, K07CA197112)
Topics
  • Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
  • Health Sciences › Medicine › Oncology › Cancer survivorship and care
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Women's cancer prevention and management
Keywords
breast cancer survivors, behavioral interventions, adjuvant endocrine therapy, tamoxifen, hormone receptor-positive breast cancer, treatment persistence, teaching materials, physician-patient communication, social support
MeSH terms
Behavior Therapy, Breast Neoplasms, Clinical Trials as Topic, Female, Humans, Physician-Patient Relations, Social Support, Tamoxifen, Chemotherapy, Adjuvant, Premenopause, Postmenopause, Survivors, Antineoplastic Agents, Hormonal, Medication Adherence

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