Patient Preference and Adherence (May 2021)

Adherence to Adjuvant Tamoxifen in Mexican Young Women with Breast Cancer

  • Martinez-Cannon BA,
  • Castro-Sanchez A,
  • Barragan-Carrillo R,
  • de la Rosa Pacheco S,
  • Platas A,
  • Fonseca A,
  • Vega Y,
  • Bojorquez-Velazquez K,
  • Bargallo-Rocha JE,
  • Mohar A,
  • Villarreal-Garza C

Journal volume & issue
Vol. Volume 15
pp. 1039 – 1049

Abstract

Read online

Bertha Alejandra Martinez-Cannon,1,2 Andrea Castro-Sanchez,2 Regina Barragan-Carrillo,2 Sylvia de la Rosa Pacheco,1 Alejandra Platas,2,3 Alan Fonseca,2,3 Yoatzin Vega,2 Karen Bojorquez-Velazquez,3 Juan Enrique Bargallo-Rocha,2,3 Alejandro Mohar,3,4 Cynthia Villarreal-Garza1,2 1Breast Cancer Center, Hospital Zambrano Hellion TecSalud, Tecnologico de Monterrey, San Pedro Garza Garcia, Mexico; 2Joven & Fuerte: Programa para la Atencion e Investigacion de Mujeres Jovenes con Cancer de Mama, Mexico City, Mexico; 3Departamento de Investigacion y de Tumores Mamarios, Instituto Nacional de Cancerologia, Mexico City, Mexico; 4Instituto de Investigaciones Biomédicas de la Universidad Nacional Autónoma de México, Mexico City, MexicoCorrespondence: Cynthia Villarreal-GarzaBreast Cancer Center, Hospital Zambrano Hellion TecSalud, Tecnologico de Monterrey, Av. Batallon de San Patricio 112, Real San Agustin, 66278, San Pedro Garza Garcia, Nuevo Leon, MexicoEmail [email protected]: Breast cancer (BC) in young women is characterized by an unfavorable prognosis in hormone receptor-positive/HER2-negative tumors, which may be explained by low rates of tamoxifen adherence. In Mexico, up to 14% of all BC diagnoses occur in young women and no data on tamoxifen adherence has been reported.Objective: To estimate the rate of adherence to adjuvant tamoxifen in Mexican young women with BC (YWBC).Methods: A cross-sectional survey was conducted at the National Cancer Institute in Mexico City, among YWBC (≤ 40 years at diagnosis) receiving adjuvant tamoxifen. Adherence was measured subjectively, through self-reported surveys, and objectively, through medication possession ratio (MPR). Descriptive statistics were used to analyze sociodemographic characteristics. To compare associations between patients’ characteristics and adherence, Chi-square test was used for categorical variables and Student’s t-test or Mann–Whitney U-test for quantitative variables.Results: A total of 141 YWBC receiving adjuvant tamoxifen were included. Regarding subjective adherence, 95% expressed taking tamoxifen regularly, 70% reported missing 0 doses in the past 30 days, and 71.6% reported having adverse effects. Regarding objective adherence, 74.8% of patients had an MPR ≥ 80%. The association between subjective and objective adherence was statistically significant (p = 0.004). Subjective adherence was associated with not skipping tamoxifen doses when feeling worse. Objective adherence was associated with having a stable job, not skipping tamoxifen doses when feeling worse, taking additional medications, and time on tamoxifen treatment. Fifty-six percent considered the information on tamoxifen to be insufficient and 37% not understandable.Conclusion: In our study, high subjective and objective adherence rates to adjuvant tamoxifen were reported, although an important proportion of women reported high rates of adverse effects and not fully understanding the benefits of tamoxifen. Strategies to increase tamoxifen adherence may be even more important now that longer durations of treatment or further ovarian function suppression have become the standard of care in YWBC.Keywords: young women, breast cancer, tamoxifen, adherence, Mexico

Keywords