ONS Connections: Pretreatment depression, anxiety, and poor physical functioning associated with non-adherence to hormonal therapy in breast cancer patients

PHOENIX—Taking a lower percentage of prescribed doses of hormonal therapy was associated with higher pre-therapy levels of depression and anxiety and with poorer physical functioning, according to research presented at the Oncology Nursing Society (ONS) Connections: Advancing Care Through Science conference. These factors were also associated with a lower percentage of days with correct intake.

Adhering to oral hormonal therapy is critical to delaying disease recurrence and reducing mortality among women with breast cancer. This study sought to understand which patient-related factors are associated with nonadherence to hormonal therapy, and if certain women are at greater risk for nonadherence.

The research team recruited 91 women who had hormone-receptor positive, early-stage breast cancer to participate in this prospective, longitudinal study. Prior to beginning hormonal therapy, depression, anxiety, and physical functioning were measured. Over 18 months, nonadherence was continuously tracked by monitoring electronic events. This monitoring yielded the percentage of prescribed doses taken and the percentage of days with correct intake.

The patients had an average age of 56.7 years, were mostly white (96.7%), and were well educated (mean of 14.9 years of schooling). The patients were not found to be depressed or anxious. Over time, a linear decrease in the percentage of prescribed doses taken and the percentage of days with correct intake occurred.

Both lower percentage of prescribed doses taken and percentage of days with correct intake had significant relationships with higher pre-therapy levels of depression and anxiety, and poorer physical functioning. The researchers concluded that those women who experience depression, anxiety, or poor physical functioning at pretreatment are those who are at risk for nonadherence to adjuvant hormonal therapy over time.

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