The impact of medication side effects on adherence and persistence to hormone therapy in breast cancer survivors: A qualitative systematic review and thematic synthesis

Nicola Peddie; Sommer Agnew; Megan Crawford; Diane Dixon; Iain MacPherson; Leanne Fleming

doi:10.1016/j.breast.2021.05.005

The impact of medication side effects on adherence and persistence to hormone therapy in breast cancer survivors: A qualitative systematic review and thematic synthesis

Nicola Peddie, Sommer Agnew, Megan Crawford, Diane Dixon, Iain MacPherson, Leanne Fleming^*

^*Corresponding author for this work

Applied Health Sciences

Research output: Contribution to journal › Review article › peer-review

37 Citations (Scopus)

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Abstract

Background: Hormone Therapy (HT) reduces the risk of breast cancer recurrence and mortality in women with breast cancer. Despite these clinical benefits, rates of HT non-adherence and non-persistence are high. Research suggests this may be due to the impact of HT side effects. However, little research has explored the individual contribution of side effects to non-adherence and non-persistence behaviours, thereby hindering the implementation of targeted intervention strategies. Our aim is to review the published literature on breast cancer survivors’ lived experiences of HT side effects and explore how these may be related to non-adherence and non-persistence behaviour. Methods: Electronic searches were conducted from inception to May 2020, utilising Cochrane CENTRAL, Medline, Embase, Web of Science and PsycINFO databases. Searches included a combination of terms related to breast cancer, adherence, hormone therapy and side effects. Results: Sixteen eligible papers were identified, and study quality was high. Data were thematically synthesised into four analytical themes, which encompassed 13 descriptive sub-themes: ‘Daily impact of side-effects’, ‘Role of Health Care Professionals’, ‘Managing HT side-effects’, and ‘Weighing up the pros and cons’. Conclusions: HT side effects significantly impact breast cancer survivor's quality of life. A lack of support from healthcare providers leads to self-management strategies, which negatively affects adherence and persistence behaviour.

Original language	English
Pages (from-to)	147-159
Number of pages	13
Journal	Breast
Volume	58
Early online date	17 May 2021
DOIs	https://doi.org/10.1016/j.breast.2021.05.005
Publication status	Published - 1 Aug 2021

Bibliographical note

The authors would like to thank the Chief Scientist Office for supporting this research.

Funding Information:
This work was supported by a Chief Scientist Office Catalytic Research Grant ( CGA/19/62 ).

The protocol for this review is available on PROSPERO (CRD42020192481).

Keywords

Adherence
Adjuvant hormone therapy
Aromatase inhibitor
Breast cancer
Endocrine therapy
Persistence
Qualitative
Side effects
Tamoxifen

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Cite this

@article{61f26b1699474cd6a2d6d0552a869417,

title = "The impact of medication side effects on adherence and persistence to hormone therapy in breast cancer survivors: A qualitative systematic review and thematic synthesis",

abstract = "Background: Hormone Therapy (HT) reduces the risk of breast cancer recurrence and mortality in women with breast cancer. Despite these clinical benefits, rates of HT non-adherence and non-persistence are high. Research suggests this may be due to the impact of HT side effects. However, little research has explored the individual contribution of side effects to non-adherence and non-persistence behaviours, thereby hindering the implementation of targeted intervention strategies. Our aim is to review the published literature on breast cancer survivors{\textquoteright} lived experiences of HT side effects and explore how these may be related to non-adherence and non-persistence behaviour. Methods: Electronic searches were conducted from inception to May 2020, utilising Cochrane CENTRAL, Medline, Embase, Web of Science and PsycINFO databases. Searches included a combination of terms related to breast cancer, adherence, hormone therapy and side effects. Results: Sixteen eligible papers were identified, and study quality was high. Data were thematically synthesised into four analytical themes, which encompassed 13 descriptive sub-themes: {\textquoteleft}Daily impact of side-effects{\textquoteright}, {\textquoteleft}Role of Health Care Professionals{\textquoteright}, {\textquoteleft}Managing HT side-effects{\textquoteright}, and {\textquoteleft}Weighing up the pros and cons{\textquoteright}. Conclusions: HT side effects significantly impact breast cancer survivor's quality of life. A lack of support from healthcare providers leads to self-management strategies, which negatively affects adherence and persistence behaviour.",

keywords = "Adherence, Adjuvant hormone therapy, Aromatase inhibitor, Breast cancer, Endocrine therapy, Persistence, Qualitative, Side effects, Tamoxifen",

author = "Nicola Peddie and Sommer Agnew and Megan Crawford and Diane Dixon and Iain MacPherson and Leanne Fleming",

note = "The authors would like to thank the Chief Scientist Office for supporting this research. Funding Information: This work was supported by a Chief Scientist Office Catalytic Research Grant ( CGA/19/62 ). The protocol for this review is available on PROSPERO (CRD42020192481).",

year = "2021",

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doi = "10.1016/j.breast.2021.05.005",

language = "English",

volume = "58",

pages = "147--159",

journal = "Breast",

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T2 - A qualitative systematic review and thematic synthesis

AU - Peddie, Nicola

AU - Agnew, Sommer

AU - Crawford, Megan

AU - Dixon, Diane

AU - MacPherson, Iain

AU - Fleming, Leanne

N1 - The authors would like to thank the Chief Scientist Office for supporting this research. Funding Information: This work was supported by a Chief Scientist Office Catalytic Research Grant ( CGA/19/62 ). The protocol for this review is available on PROSPERO (CRD42020192481).

PY - 2021/8/1

Y1 - 2021/8/1

N2 - Background: Hormone Therapy (HT) reduces the risk of breast cancer recurrence and mortality in women with breast cancer. Despite these clinical benefits, rates of HT non-adherence and non-persistence are high. Research suggests this may be due to the impact of HT side effects. However, little research has explored the individual contribution of side effects to non-adherence and non-persistence behaviours, thereby hindering the implementation of targeted intervention strategies. Our aim is to review the published literature on breast cancer survivors’ lived experiences of HT side effects and explore how these may be related to non-adherence and non-persistence behaviour. Methods: Electronic searches were conducted from inception to May 2020, utilising Cochrane CENTRAL, Medline, Embase, Web of Science and PsycINFO databases. Searches included a combination of terms related to breast cancer, adherence, hormone therapy and side effects. Results: Sixteen eligible papers were identified, and study quality was high. Data were thematically synthesised into four analytical themes, which encompassed 13 descriptive sub-themes: ‘Daily impact of side-effects’, ‘Role of Health Care Professionals’, ‘Managing HT side-effects’, and ‘Weighing up the pros and cons’. Conclusions: HT side effects significantly impact breast cancer survivor's quality of life. A lack of support from healthcare providers leads to self-management strategies, which negatively affects adherence and persistence behaviour.

AB - Background: Hormone Therapy (HT) reduces the risk of breast cancer recurrence and mortality in women with breast cancer. Despite these clinical benefits, rates of HT non-adherence and non-persistence are high. Research suggests this may be due to the impact of HT side effects. However, little research has explored the individual contribution of side effects to non-adherence and non-persistence behaviours, thereby hindering the implementation of targeted intervention strategies. Our aim is to review the published literature on breast cancer survivors’ lived experiences of HT side effects and explore how these may be related to non-adherence and non-persistence behaviour. Methods: Electronic searches were conducted from inception to May 2020, utilising Cochrane CENTRAL, Medline, Embase, Web of Science and PsycINFO databases. Searches included a combination of terms related to breast cancer, adherence, hormone therapy and side effects. Results: Sixteen eligible papers were identified, and study quality was high. Data were thematically synthesised into four analytical themes, which encompassed 13 descriptive sub-themes: ‘Daily impact of side-effects’, ‘Role of Health Care Professionals’, ‘Managing HT side-effects’, and ‘Weighing up the pros and cons’. Conclusions: HT side effects significantly impact breast cancer survivor's quality of life. A lack of support from healthcare providers leads to self-management strategies, which negatively affects adherence and persistence behaviour.

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KW - Adjuvant hormone therapy

KW - Aromatase inhibitor

KW - Breast cancer

KW - Endocrine therapy

KW - Persistence

KW - Qualitative

KW - Side effects

KW - Tamoxifen

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DO - 10.1016/j.breast.2021.05.005

M3 - Review article

AN - SCOPUS:85106531943

SN - 0960-9776

VL - 58

SP - 147

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JO - Breast

JF - Breast

ER -

The impact of medication side effects on adherence and persistence to hormone therapy in breast cancer survivors: A qualitative systematic review and thematic synthesis

Abstract

Bibliographical note

Keywords

UN SDGs

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