Many Breast Cancer Patients Don't Take Their Hormone Meds, Study Looks at How to Change That
Michelle Milliken
Following initial breast cancer treatment, hormone therapy is typically prescribed for patients with hormone receptor-positive cancers. That can include treatments like estrogen blockers or aromatase inhibitors. Though they’ve been linked with a lower risk of recurrence and death, many women don’t take them as prescribed. A new study investigated how best to discourage that.
Research recently published in the Journal of Clinical Oncology analyzed 25 studies involving nearly 370,000 women who had been prescribed hormone therapy for breast cancer. The goal was to learn how best to boost adherence to medication directions. They found that addressing cost issues, utilizing emotional reminders, and symptom-mitigating approaches were all helpful.
Joanna Arch, senior author and professor in the Department of Psychology and Neuroscience at the University of Colorado Boulder, explains, “Our bottom-line finding is that there are strategies that do work in supporting women to take these life-extending medications, and that we as a cancer care community need to do better.”
In terms of doing better, the team found that merely educating patients on what to expect was not necessarily enough. The side effects of these treatments run the gamut, from hot flashes and vaginal dryness to bone and muscle issues. Depression is also possible. If these were communicated via pamphlets or explanations from a doctor, it was unlikely to increase the chances of a patient taking their medications as prescribed.
Helping mitigate the symptoms was found to be helpful, though, with methods like physical therapy, exercise, and behavioral counseling.
As with many other health conditions, like diabetes, the cost of medications can often get in the way of being able to take them, as well. The researchers found that policy changes lowering costs, like offering generic alternatives or requiring insurance companies to cover pills the same as infusions, were linked with better uptake of medications.
Reminding patients of what they may enjoy with continued health was an effective strategy, too. Arch herself did a study that was involved in the meta-analysis. In that study, participants were asked for the main reason they were taking the medications. That could include being around to see loved ones grow up or personal goals they hoped to accomplish. They then printed out a sticker with this goal and placed it on their pill box.
Through the first month of study, participants who did this were more apt to take their pills as directed than those who did not print out their own sticker.
Next up, Arch hopes to see how addressing mental health may work.
She explains, “One of the most consistent predictors of not adhering to any medication is depression. Depression taps motivation.”
She’s begun a pilot trial to investigate how treating depression may help. She says that while these other approaches have helped increase medication uptake by nearly 1.5 times, that’s relatively modest and more work needs to be done.
