Adjuvant hormonal therapy use among insured, low-income women with breast cancer

Kimmick, Gretchen; Anderson, Roger; Camacho, Fabian; Bhosle, Monali; Hwang, Wenke; Balkrishnan, Rajesh

doi:10.1200/jco.2008.19.2419

Cited by 198Breast Cancer Treatment StudiesGlobal Cancer Incidence and ScreeningMedication Adherence and Compliance

Adjuvant hormonal therapy use among insured, low-income women with breast cancer

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Kimmick, Gretchen, Anderson, Roger, Camacho, Fabian, Bhosle, Monali, Hwang, Wenke, Balkrishnan, Rajesh·2009·Journal of Clinical Oncology

DOI 10.1200/jco.2008.19.2419PMC PMC2717752

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Abstract

Purpose: Use of adjuvant hormonal therapy, which significantly decreases breast cancer mortality, has not been well described among poor women, who are at higher risk of cancer-related death. Here we explore use of adjuvant hormonal therapy in an insured, low-income population. Methods: A North Carolina Cancer Registry–Medicaid linked data set was used. Women with hormone receptor–positive or unknown, nonmetastatic breast cancer, diagnosed between 1998 and 2002, were included. Main outcomes were (1) prescription fill within 1 year of diagnosis, (2) adherence (medication possession ratio), and (3) persistence (absence of a 90-day gap in prescription fills over 12 months). Results: The population consisted of 1,491 women (mean age, 67 years). Sixty-four percent filled prescriptions. Predictors of prescription fill included the following: older age (odds ratio [OR], 1.01; P = .017), greater number of prescription medications (OR, 1.06; P < .001), nonmarried status (OR, 1.82; P = .001), higher stage (OR, 1.83; P < .001), positive hormone receptor status (positive v unknown, OR, 1.98; P < .001), not receiving adjuvant chemotherapy (OR, 1.74; P = .001), receipt of adjuvant radiation (OR, 1.55; P = .004), and treatment in a small hospital (OR, 1.49; P = .024). Adherence and persistence rates were 60% and 80%, respectively. Nonmarried status predicted greater adherence (OR, 1.90; P = .006) and persistence (OR, 1.75; P = .031). Conclusion: Prescription fill, adherence, and persistence to adjuvant hormonal therapy among socioeconomically disadvantaged women are low. Improving use of adjuvant hormonal therapy may lead to lower breast cancer–specific mortality in this population.

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Some research suggests that minority groups have lower adjuvant hormonal therapy adherence.
“Although there is mixed evidence,39, 40 some research suggests that minority groups have lower adjuvant hormonal therapy adherence.8, 10, 29”
From Behavioral interventions to enhance adherence to hormone therapy in breast cancer survivors: a systematic literature review (2016) · cites this paper as [8]

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Hormone therapy for cancer treatment
Devi, S. (2022) · Elsevier eBooks · doi:10.1016/b978-0-323-99883-3.00007-x · Cited by 1 · see citing works

Authors: Kimmick, G., Anderson, R., Camacho, F., Bhosle, M., Hwang, W., & Balkrishnan, R.
Affiliations: Pennsylvania State University (US)
ORCID: Kimmick, Gretchen
Anderson, Roger
Camacho, Fabian
Hwang, Wenke
Balkrishnan, Rajesh
Venue: Journal of Clinical Oncology
Publisher: American Society of Clinical Oncology (ASCO)
Published: 2009-07-20
Volume: 27
Issue: 21
Pages: 3445-3451
ISSN: 0732-183X (ISSN-L)
1527-7755
DOI: 10.1200/jco.2008.19.2419
PMC: PMC2717752
OpenAlex: W2157875208
Cited by: 198
References: 59
Citations by year: 2026: 2 · 2025: 9 · 2024: 7 · 2023: 9 · 2022: 8 · 2021: 13 · 2020: 4 · 2019: 9 · 2018: 15 · 2017: 17 · 2016: 13 · 2015: 17 · 2014: 13 · 2013: 19 · 2012: 21
FWCI: 4.80
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: Journal of Clinical Oncology (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Funders: AstraZeneca
National Cancer Institute (R01CA121317, R01-CA121317-3)
Topics: Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Breast Cancer Treatment Studies
Health Sciences › Medicine › Oncology › Global Cancer Incidence and Screening
Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
Keywords: adjuvant endocrine therapy, breast cancer, low-income women, Medicaid, prescription fills, medication adherence, treatment persistence, socioeconomic disparities, marital status, hormone receptor status, adjuvant chemotherapy, adjuvant radiotherapy, small hospitals
MeSH terms: Adjuvants, Pharmaceutic, Aged, Aged, 80 and over, Breast Neoplasms, Female, Humans, Middle Aged, Patient Compliance, Poverty, Social Class, Treatment Outcome, Chemotherapy, Adjuvant, Antineoplastic Agents, Hormonal, Prescriptions

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Adjuvant hormonal therapy use among insured, low-income women with breast cancer

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