The DOI matches its Crossref record, with a small difference in title or year; 44 of the 44 references it cites were found in a registry or an index.
Patient Centered Experiences in Breast Cancer: Predicting Long-Term Adherence to Tamoxifen Use
Abstract
BACKGROUND: Among breast cancer patients, tamoxifen use is associated with reduced risk of disease relapse and death, but it is often difficult for women to sustain therapy during the 5 years required to obtain maximum benefit. OBJECTIVES: We sought to examine the influence of patient-centered care activities on ongoing tamoxifen use 4 years after initiation, we examined key components of patient-centered care and rates of ongoing tamoxifen. METHODS: Using a prospective cohort study that included observational data from the National Initiative for Cancer Care Quality (NICCQ), we studied 881 patients with stage I-III breast cancer who were registered with an initial diagnosis in 1998 by an American College of Surgeons-approved hospital cancer registry in 1 of 5 metropolitan areas, who initiated tamoxifen treatment. A patient survey and medical record abstraction were used as measurements. RESULTS: Among women who initiated tamoxifen, 79% were still taking it 4 years later. Other than older age and the severity of side effects, other demographic, clinical and cancer characteristics, and treatments did not predict ongoing tamoxifen use. In contrast, after adjusting for these factors, the proportion of patients with ongoing tamoxifen use was lower for patients reporting less support than needed (82% vs. 69%, P = 0.0051), less than wanted role in decision-making (80% vs. 70%, P = 0.0486), decision-making about tamoxifen without doctor input (79% vs. 64%, P = 0.0182), and for patients who weren't told about side effects in advance (82% vs. 72%, P = 0.0016). CONCLUSIONS: Although age and the severity of side-effects remain important, patient-centered care was a primary mediator of patient adherence to ongoing cancer treatment with tamoxifen.
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“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”
From Behavioral interventions to enhance adherence to hormone therapy in breast cancer survivors: a systematic literature review (2016) · cites this paper as [16]
In the citing paper
“There is also evidence that survivors who reported (1) lack of understandable information about treatment, (2) not being told about side effects in advance, (3) having limited opportunity to ask questions at the time of diagnosis, and (4) never having been asked about the difficulties of taking adjuvant hormonal therapy, exhibited lower rates of adherence to hormonal treatment.16-18”
From Behavioral interventions to enhance adherence to hormone therapy in breast cancer survivors: a systematic literature review (2016) · cites this paper as [16]
In the citing paper
“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”
From Behavioral interventions to enhance adherence to hormone therapy in breast cancer survivors: a systematic literature review (2016) · cites this paper as [16]
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“Reports for adherence to tamoxifen by women with DCIS also varied widely (6, 7) and may relate to women's perceptions of less social support from health care providers (27); this may be compounded by a lack of consensus about therapy recommendations among different prescribers (28, 29).”
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“Another questionnaire study reported that discontinuation and nonadherence to endocrine therapy were lower in patients reporting a lack of support and communication, and lack of information on side effects.(15,16) Our results supported these previous studies, in that patients more likely to consult with medical staff…”
ResultMao, D., Hachem, H., Chang, H., Dima, D., Dower, J., Wismer, M., Erban, J. K., Freund, K. M., & Parsons, S. K. (2020) · Breast Cancer Research and Treatment · doi:10.1007/s10549-020-05892-z · Cited by 20
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“Positive hormone receptor status has been associated with both ongoing tamoxifen use at 4 years (Kahn et al., 2007) and with stopping tamoxifen therapy by the second year (Fink et al., 2004).”
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“Symptoms were the most important predictor of discontinuing long-term use.(38) However, even after adjustment for symptom onset and intensity, patient-centered care was the most important predictor of ongoing adjunct tamoxifen use in the setting of new onset breast cancer.”
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Metadata
- Authors
- Kahn, K. L., Schneider, E. C., Malin, J. L., Adams, J. L., & Epstein, A. M.
- Affiliations
- RAND Corporation (US)
- Brigham and Women's Hospital (US)
- Amgen (United States) (US)
- Corresponding author
- Kahn, Katherine L.
- Adams, John L.
- Venue
- Medical Care
- Published
- 2007-05
- Volume
- 45
- Issue
- 5
- Pages
- 431-439
- ISSN
- 0025-7079 (ISSN-L)
- OpenAlex
- W1979710912
- Cited by
- 245
- References
- 44
- Citations by year
- 2026: 3 · 2025: 11 · 2024: 6 · 2023: 11 · 2022: 9 · 2021: 20 · 2020: 13 · 2019: 10 · 2018: 17 · 2017: 18 · 2016: 16 · 2015: 17 · 2014: 16 · 2013: 29 · 2012: 14
- FWCI
- 12.51
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Medical Care (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Breast Cancer Treatment Studies
- Keywords
- breast cancer, tamoxifen, patient-centered care, medication adherence, patient support, shared decision-making, treatment side effects
- MeSH terms
- Adult, Aged, Aged, 80 and over, Breast Neoplasms, Female, Humans, Medical Audit, Middle Aged, Neoplasm Staging, Patient Compliance, Patient Participation, Prospective Studies, Tamoxifen, Time Factors, United States, Cohort Studies, Patient-Centered Care, Health Care Surveys
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