Predictors of patient-reported toxicities from endocrine therapy: Importance of illness perceptions, treatment beliefs, and fear of recurrence.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 542-542
Author(s):  
Xinni Song ◽  
Susan Faye Dent ◽  
Shailendra Verma ◽  
Mark J. Clemons ◽  
Nadine A. Graham ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Side Effects ◽  
Adverse Effects ◽  
Endocrine Therapy ◽  
Symptom Management ◽  
Self Report ◽  
Fear Of Cancer Recurrence ◽  
Management Interventions ◽  
Patient Reported ◽  
The Impact

542 Background: Numerous studies have documented the toxicities of endocrine therapy (ET) for early breast cancer (EBC) and their deleterious impact on quality of life and adherence. However, little is known about the factors that underlie patient's susceptibility to report toxicities. The identification of risk factors for toxicities from ET is important as it would allow early targeting of symptom management interventions for women more vulnerable to adverse effects of ET. This prospective study aims to examine the impact of pre-treatment perceptions of EBC, ET beliefs and fear of breast cancer (BC) recurrence (FBCR) on toxicities reported after 6 months of ET. Methods: Women diagnosed with EBC completed a survey prior to initiating endocrine therapy, then at 3, 6 and 12 months. Standardized self-report instruments were used to assess EBC perceptions, ET beliefs, FBCR and toxicities. Clinical and treatment variables were also evaluated. Univariate analyses and mulitivariate regression were conducted to identify factors associated (p<0.1) with side effects at 6 months. Results: Since 9/2010, 173 patients have consented and 84 (mean age = 60 y) have completed the questionnaires at baseline and after 6 months of ET. Controlling for age, none of the clinical or treatment variables (stage of disease, type of surgery, receipt of chemotherapy and radiation therapy) were significant univariate predictors of toxicities. In multiple regression, stronger perceptions that BC has serious consequences on their lives (β=0.218, p<0.05), greater concerns about the adverse effects of ET (β=0.215, p<0.05) and higher levels of FBCR (β=0.316, p<0.01) at baseline were associated with higher levels of reported toxicities. Conclusions: Baseline psychological factors predicted level of patient-reported toxicities to a larger extent than clinical/treatment factors. How patients perceived their illness, their beliefs about ET side effects and their fear of cancer recurrence are strongly associated with side effects experienced after 6 months of ET. These results could facilitate the identification of a subgroup of patients for early interventions to improve symptom management.

Barriers to patient adherence with adjuvant endocrine therapy.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 6605-6605 ◽  
Author(s):  
Jennifer Michelle Duff ◽  
Hui Yan ◽  
Myron Chang ◽  
Eric Rosenberg ◽  
Karen Colleen Daily
Keyword(s):  
Breast Cancer ◽  
Side Effects ◽  
Endocrine Therapy ◽  
Text Messaging ◽  
Patient Adherence ◽  
Adjuvant Endocrine Therapy ◽  
Pharmacy Records ◽  
Electronic Reminder ◽  
Patient Reported ◽  
The Impact

6605 Background: Adjuvant endocrine therapy for hormone receptor positive breast cancer is essential to decreasing recurrence and improving survival. However, adherence to these drugs has been reported to be suboptimal, the impact of which on breast cancer outcomes is unknown. Multiple non-modifiable risk factors have been associated with nonadherence. Identifying patients’ self-reported reasons for not taking these drugs as prescribed may be crucial to improving adherence. Methods: We obtained data from 49 women prescribed tamoxifen, letrozole, anastrozole, or exemestane for stage I-III invasive breast cancer. Written surveys were provided during the patients’ medical oncology visits. Our study collected demographic data on patient characteristics associated with nonadherence. Patients were asked to report reasons for missing doses including forgetting to take the drug, side effects, cost, and barriers to refill. Patients described their degree of adherence by identifying how often they miss a dose as never, once per month, once per week, or more than once per week. We compared their self-reported adherence to pharmacy refill records. Results: More than half the women (26 of 49) report regularly missing doses of their drug over the last year. Of these, 22 miss once per month, 3 miss once per week, and 1 misses more than once per week. Despite this, pharmacy records verified consistent refills in all 26 less adherent patients over the past year. The most common reason identified for missed doses (21 of 26) was forgetting to take the drug, followed by barriers to refill and side effects. 57% of all patients favored receiving an electronic reminder via text messaging or email. Nonadherence was associated with polypharmacy and lower levels of education, income, and activity. Conclusions: Our study provides insight into patient reported reasons for nonadherence to adjuvant endocrine therapy. Our patients reported forgetting to take their drug as most problematic. Patients’ self-reported adherence was confirmed (96%) by pharmacy records. Most patients are interested in an electronic reminder system via e-mail or text messaging, even if they report complete adherence. This has potential to be a cost effective intervention.

Endocrine therapy adherence of premenopausal Mexican breast cancer patients.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e12510-e12510
Author(s):  
Cynthia Villarreal-Garza ◽  
Fernanda Mesa-Chavez ◽  
Ana Sofia Ferrigno ◽  
Cynthia De la Garza-Ramos ◽  
Karen Villanueva-Tamez ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Adverse Effects ◽  
Endocrine Therapy ◽  
Ovarian Function ◽  
Hot Flashes ◽  
Self Report ◽  
Categorical Variables ◽  
Considerable Proportion ◽  
Ovarian Function Suppression ◽  
Age Related

e12510 Background: Among premenopausal women with breast cancer (BC), adherence to endocrine therapy (ET) has often been reported suboptimal due to age-related adverse effects, lack of understandable information and inadequate social support. The current increased use of ovarian function suppression (OFS) may lead to even lower adherence rates in this group due to its high adverse effects profile. This study aims to assess the extent to which premenopausal patients comply with ET and to identify factors that hinder optimal adherence in Mexico. Methods: Women aged ≤50 years with primary stage I-III hormone receptor-positive BC receiving adjuvant ET for ≥1year were invited to fill a survey regarding their attitude towards ET and self-reported adherence. Fisher’s exact test was used to explore associations between categorical variables. This study was funded by AstraZeneca Mexico. Results: From Sep 2019 to Jan 2020, 127 patients with a median age of 45 years (range: 25-50) were included. Most had at least high school education (64%) and were unemployed (61%). ET distribution was: 69% tamoxifen (TMX) alone; 2% TMX switch to aromatase inhibitor (AI); 29% OFS plus TMX/AI. All patients recognized ET as a necessary part of their treatment and 97% believed it reduced their recurrence risk, yet 14% considered they had not received enough information about ET. Adverse effects were reported by 98%, predominantly hot flashes (82%), arthralgias (59%) and fatigue (58%). A statistically significant higher proportion of patients treated with a switch strategy or OFS experienced hot flashes, headache, insomnia, decreased libido and dyspareunia than those with TMX alone. Only 59% claimed their physician had taken measures to reduce these symptoms. Overall, 93% reported complete ET adherence. Nonetheless, 22% of them subsequently acknowledged missing 1-6 doses in the last month, the most common reasons being forgetfulness (78%), adverse effects (27%) and unwillingness to take the medication (11%). Unemployed patients were more likely to report daily compliance than students/employees (79% vs 60%; p = 0.02). No significant differences in adherence were found according to other factors, including type of ET. Conclusions: Premenopausal Mexican women self-report remarkably high rates of ET adherence. However, a considerable proportion misses ≥1 doses/month, with forgetfulness as the most common cause particularly in students/employees. Interventions aimed at reminding this group to take their ET and managing adverse effects could be crucial to improve adherence and, consequently, disease outcomes.

scholarly journals Adverse effects of adjuvant endocrine therapy

2018 ◽  
pp. 64-69
Author(s):  
E. I. Kovalenko ◽  
I. B. Kononenko ◽  
A. V. Snegovoi ◽  
O. P. Grebennikova ◽  
L. V. Manzyuk
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Side Effects ◽  
Adverse Effects ◽  
Adverse Events ◽  
Endocrine Therapy ◽  
Aromatase Inhibitors ◽  
Hormonal Therapy ◽  
Adjuvant Endocrine Therapy

Hormonal therapy is a highly effective and well tolerable treatment of hormone-responsive breast cancer. However, it has some side effects that can affect quality of life and lead to treatment discontinuation. Common side effects of tamoxifen and aromatase inhibitors are discussed in this article: menopausal, gynecological symptoms, cardiovascular and musculoskeletal adverse events. Some of them are preventable and manageable. In order to maintain good quality of life during treatment the oncologists should pay more attention to the side effects that lead to it’s deterioration and not be too anxious about insignificant ones.

scholarly journals Patient-Reported Discontinuation of Endocrine Therapy and Related Adverse Effects Among Women With Early-Stage Breast Cancer

2012 ◽  
Vol 8 (6) ◽  
pp. e149-e157 ◽  
Author(s):  
Erin J. Aiello Bowles ◽  
Denise M. Boudreau ◽  
Jessica Chubak ◽  
Onchee Yu ◽  
Monica Fujii ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Adverse Effects ◽  
Endocrine Therapy ◽  
Early Stage ◽  
Patient Characteristics ◽  
Early Stage Breast Cancer ◽  
Therapy Discontinuation ◽  
Patient Reported

Few individual adverse effects or patient characteristics were significantly associated with endocrine therapy discontinuation, yet adverse effects were prevalent and were the most commonly reported reason for discontinuation.

Patient-reported use of marijuana and cannabinoid (CBD) oil in patients with renal cell carcinoma undergoing systemic therapy.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 5084-5084
Author(s):  
Dena Battle ◽  
Cristiane Decat Bergerot ◽  
Pavlos Msaouel ◽  
Tian Zhang ◽  
Daniel J. George ◽  
...  
Keyword(s):  
Side Effects ◽  
Systemic Therapy ◽  
Treatment Duration ◽  
Online Survey ◽  
Self Report ◽  
Hormone Substitution ◽  
Systemic Treatments ◽  
Number Of Patients ◽  
Patient Reported ◽  
The Impact

5084 Background: The use of cannabis and cannabinoid related products has become increasingly common among cancer patients. We sought to gather independent data from online kidney cancer patient communities to assess frequency of use of marijuana and CBD-oil and estimate influence on treatment duration and side-effects. Methods: The KCCure online survey was performed between August 1, and September 30, 2019. Descriptive statistics were used to characterize patients who self-report using marijuana, their systemic treatments, and interactions with their oncologists. Results: Out of 1,136 patients responding, 411 patients were on systemic therapy with a median age of 57 years (28-86). Of the 441 patients with systemic therapy, 223 patients (54%) were male. There was no difference in gender distribution or race among patients who reported using or not using marijuana and or CBD oil. 93 patients (21%) reported using marijuana or CBD oil and 35 patients (8.5%) reported using both. Patients using marijuana and/or CBD oil had a median age of 55.7 +/- 1.1 years compared with patients not using (65.1 +/- 6.9 years). The median treatment duration was 23.9+/-2.4 months for patients using marijuana and/or CBD oil versus 26.4+/- 1.9 months for patients not using these supplements (p=0.437). Patients using marijuana and/or CBD oil were more likely to have bothersome side effects from therapy (p=0.001) and were less likely to talk to their doctor about their situation (p=0.044). The median NCCN distress score in patients using marijuana and/or CBD oil was 49.5+/-25.7 versus 51.4+/-24.0 (p n.s.). No correlation was seen with the use of steroids, anti-diarrhea drugs, anti-nausea-drugs, hormone substitution or other drugs used to manage side effects. Conclusions: Marijuana and/or CBD oil are used by a significant number of patients. No benefit/harm on treatment duration and use of concomitant drugs to control side effects and severity was seen. Patients using marijuana and/or CBD oil were more likely to report bothersome treatment related side effects and were more willing to report their side effects to their provider. As cannabinoids become more mainstream and legal in a number of states, more research is needed to better understand the impact these supplements may have on patients.

scholarly journals Global Impact of COVID-19 on Weight and Weight-Related Behaviors in the Adult Population: A Scoping Review

2021 ◽  
Vol 18 (4) ◽  
pp. 1876
Author(s):  
Han Shi Jocelyn Chew ◽  
Violeta Lopez
Keyword(s):  
Weight Gain ◽  
Scoping Review ◽  
Screen Time ◽  
Weight Status ◽  
Adult Population ◽  
Self Report ◽  
Future Research ◽  
Sedentary Behaviors ◽  
Management Interventions ◽  
The Impact

Objective: To provide an overview of what is known about the impact of COVID-19 on weight and weight-related behaviors. Methods: Systematic scoping review using the Arksey and O’Malley methodology. Results: A total of 19 out of 396 articles were included. All studies were conducted using online self-report surveys. The average age of respondents ranged from 19 to 47 years old, comprised of more females. Almost one-half and one-fifth of the respondents gained and lost weight during the COVID-19 pandemic, respectively. Among articles that examined weight, diet and physical activity changes concurrently, weight gain was reported alongside a 36.3% to 59.6% increase in total food consumption and a 67.4% to 61.4% decrease in physical activities. Weight gain predictors included female sex, middle-age, increased appetite, snacking after dinner, less physical exercise, sedentary behaviors of ≥6 h/day, low water consumption and less sleep at night. Included articles did not illustrate significant associations between alcohol consumption, screen time, education, place of living and employment status, although sedentary behaviors, including screen time, did increase significantly. Conclusions: Examining behavioral differences alone is insufficient in predicting weight status. Future research could examine differences in personality and coping mechanisms to design more personalized and effective weight management interventions.

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