Title |
Adherence to adjuvant hormone therapy in low-income women with breast cancer: the role of provider–patient communication
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Published in |
Breast Cancer Research and Treatment, December 2012
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DOI | 10.1007/s10549-012-2387-8 |
Pubmed ID | |
Authors |
Yihang Liu, Jennifer L. Malin, Allison L. Diamant, Amardeep Thind, Rose C. Maly |
Abstract |
To assess the impact of patient-provider communication on adherence to tamoxifen (TAM) and aromatase inhibitors (AIs) 36 months after breast cancer (BC) diagnosis in a low-income population of women. California statewide surveys were conducted among 921 low-income women with BC at 6, 18, and 36 months after BC diagnosis. A subset of 303 women with stage I-III BC who initiated hormone treatment after diagnosis was identified. Bivariate and multivariate logistic regression analyses were performed, and adjusted adherence rates were calculated. The main outcome measure was self-reported hormone use at 36 months after BC diagnosis and the chief independent variables were patient-centered communication after diagnosis by patient report as measured by the Consumer Assessment of Healthcare Providers and Systems (CAHPS) and patients' self-efficacy in patient-physician interactions (PEPPI). Overall adherence to TAM/AI was relatively high (88 %). Adjusted rates of adherence were 59 and 94 % for patients with the lowest versus highest scores on the CAHPS communication scale (AOR = 1.22, P = 0.006) and 72 versus 91 % for patients with the lowest and highest rating of PEPPI (AOR = 1.04, P = 0.04). Having at least one comorbid condition also increased the odds of adherence to hormonal therapy (AOR = 3.14, P = 0.03). Having no health insurance and experiencing side-effects from hormone treatment were barriers for adherence (AOR = 0.12, P = 0.001; AOR = 0.26, P = 0.003, respectively). Patient-centered communication and perceived self-efficacy in patient-physician interaction were significantly associated with patient adherence to ongoing TAM/AI therapy among low-income women with BC. Interventions on patient-provider communication may provide opportunities to improve patient outcomes in this vulnerable population. |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
United States | 1 | <1% |
Unknown | 120 | 99% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Researcher | 20 | 17% |
Student > Ph. D. Student | 18 | 15% |
Student > Master | 18 | 15% |
Student > Bachelor | 10 | 8% |
Student > Doctoral Student | 8 | 7% |
Other | 21 | 17% |
Unknown | 26 | 21% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 28 | 23% |
Nursing and Health Professions | 21 | 17% |
Psychology | 19 | 16% |
Social Sciences | 8 | 7% |
Pharmacology, Toxicology and Pharmaceutical Science | 3 | 2% |
Other | 12 | 10% |
Unknown | 30 | 25% |