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 A major problem in medicine in general is when people don’t take
their medication as prescribed, said lead author Dr. Alfred Neugut,
of Columbia University Medical Center in New York City.
"It’s kind of well known, but not generally spoken about," he told
Reuters Health.
The problem, known as nonadherence, also extends to cancer
medicines, even though they are generally viewed as life-saving or
life-prolonging, he and his colleagues write in JAMA Oncology.
They add that 30 to 50 percent of women in previous studies
prematurely discontinued hormone therapy, which blocks the hormone
estrogen from reaching the cancer and helping it grow.
To see if past behavior could predict women's adherence to hormone
therapy, the researchers used insurance data from 21,255 women
diagnosed between 2010 and 2012 with breast cancer that had not
spread to other parts of the body. The women had all filled at least
two prescriptions for hormone therapy.
Sixty-three percent had previously been prescribed at least one
medication for high blood pressure, excess fats in the blood, acid
reflux, thyroid problems, diabetes or thinning bones.
Based on when the women refilled their prescriptions, about 16
percent appeared to be nonadherent to their hormone therapy.
Among women who had taken as directed at least one medication for a
chronic condition, about one in 10 didn't stick to their hormone
therapy. By comparison, about one in five women who had never been
prescribed drugs for a chronic condition were non-adherent to their
hormone therapy, as were nearly one in four women who had not
adhered to past chronic condition prescriptions.
"If you were nonadherent to your hypertension or other pills, you
were likely to be nonadherent with your (hormone therapy) pills and
vice versa," Neugut said.
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High out-of-pocket costs and a high number of other health problems
were also tied to an increased likelihood of nonadherence to hormone
therapy.
"Whatever trait it is in you, whatever your personal quirk is that
makes you obsessive compulsive or sloppy about your pill taking,
that holds true for your chronic disease pills or oncology pills,"
Neugut said.
The results can't be generalized to everyone since nearly all the
participants had insurance, the researchers write. Additionally, the
authors lacked information on other factors that may have influenced
adherence.
Neugut is working now to see if text reminders may increase
adherence to hormone therapy, but those results won't be published
for several months.
The new study helps identify women who should be targeted with
interventions to increase adherence, he said.
SOURCE: http://bit.ly/1UG3rHZ JAMA Oncology, online June 8, 2016.
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