Oral Endocrine Therapy Nonadherence, Adverse Effects, Decisional Support, and Decisional Needs in Women With Breast Cancer

Jennifer L. Milata, Julie Otte, Janet Carpenter

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

BACKGROUND:: Oral endocrine therapy (OET) such as tamoxifen or aromatase inhibitors reduces recurrence and mortality for the 75% of breast cancer survivors (BCSs) with a diagnosis of estrogen receptor–positive breast cancer. Because many BCSs decide not take OET as recommended because of adverse effects, understanding BCSs’ decisional supports and needs is foundational to supporting quality OET decision making about whether to adhere to OET. OBJECTIVE:: The aim of this study was to examine literature pertaining to OET nonadherence and adverse effects using the Ottawa Decision Support Framework categories of decisional supports and decisional needs because these factors potentially influence OET use. METHODS:: A systematic literature search was performed in PubMed and CINAHL using combined search terms “aromatase inhibitors and adherence” and “tamoxifen and adherence.” Studies that did not meet criteria were excluded. Relevant data from 25 publications were extracted into tables and reviewed by 2 authors. RESULTS:: Findings identified the impact of adverse effects on OET nonadherence, an absence of decisional supports provided to or available for BCSs who are experiencing OET adverse effects, and the likelihood of unmet decisional needs related to OET. CONCLUSIONS:: Adverse effects contribute to BCSs decisions to stop OET, yet there has been little investigation of the process through which that occurs. This review serves as a call to action for providers to provide support to BCSs experiencing OET adverse effects and facing decisions related to nonadherence. IMPLICATIONS FOR PRACTICE:: Findings suggest BCSs prescribed OET have unmet decisional needs, and more decisional supports are needed for BCSs experiencing OET adverse effects.

Original languageEnglish (US)
JournalCancer Nursing
DOIs
StateAccepted/In press - Aug 16 2016

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Breast Neoplasms
Survivors
Therapeutics
Aromatase Inhibitors
Tamoxifen
PubMed
Publications
Decision Making
Estrogens
Recurrence
Mortality

ASJC Scopus subject areas

  • Oncology
  • Oncology(nursing)

Cite this

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title = "Oral Endocrine Therapy Nonadherence, Adverse Effects, Decisional Support, and Decisional Needs in Women With Breast Cancer",
abstract = "BACKGROUND:: Oral endocrine therapy (OET) such as tamoxifen or aromatase inhibitors reduces recurrence and mortality for the 75{\%} of breast cancer survivors (BCSs) with a diagnosis of estrogen receptor–positive breast cancer. Because many BCSs decide not take OET as recommended because of adverse effects, understanding BCSs’ decisional supports and needs is foundational to supporting quality OET decision making about whether to adhere to OET. OBJECTIVE:: The aim of this study was to examine literature pertaining to OET nonadherence and adverse effects using the Ottawa Decision Support Framework categories of decisional supports and decisional needs because these factors potentially influence OET use. METHODS:: A systematic literature search was performed in PubMed and CINAHL using combined search terms “aromatase inhibitors and adherence” and “tamoxifen and adherence.” Studies that did not meet criteria were excluded. Relevant data from 25 publications were extracted into tables and reviewed by 2 authors. RESULTS:: Findings identified the impact of adverse effects on OET nonadherence, an absence of decisional supports provided to or available for BCSs who are experiencing OET adverse effects, and the likelihood of unmet decisional needs related to OET. CONCLUSIONS:: Adverse effects contribute to BCSs decisions to stop OET, yet there has been little investigation of the process through which that occurs. This review serves as a call to action for providers to provide support to BCSs experiencing OET adverse effects and facing decisions related to nonadherence. IMPLICATIONS FOR PRACTICE:: Findings suggest BCSs prescribed OET have unmet decisional needs, and more decisional supports are needed for BCSs experiencing OET adverse effects.",
author = "Milata, {Jennifer L.} and Julie Otte and Janet Carpenter",
year = "2016",
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language = "English (US)",
journal = "Cancer Nursing",
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AU - Milata, Jennifer L.

AU - Otte, Julie

AU - Carpenter, Janet

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N2 - BACKGROUND:: Oral endocrine therapy (OET) such as tamoxifen or aromatase inhibitors reduces recurrence and mortality for the 75% of breast cancer survivors (BCSs) with a diagnosis of estrogen receptor–positive breast cancer. Because many BCSs decide not take OET as recommended because of adverse effects, understanding BCSs’ decisional supports and needs is foundational to supporting quality OET decision making about whether to adhere to OET. OBJECTIVE:: The aim of this study was to examine literature pertaining to OET nonadherence and adverse effects using the Ottawa Decision Support Framework categories of decisional supports and decisional needs because these factors potentially influence OET use. METHODS:: A systematic literature search was performed in PubMed and CINAHL using combined search terms “aromatase inhibitors and adherence” and “tamoxifen and adherence.” Studies that did not meet criteria were excluded. Relevant data from 25 publications were extracted into tables and reviewed by 2 authors. RESULTS:: Findings identified the impact of adverse effects on OET nonadherence, an absence of decisional supports provided to or available for BCSs who are experiencing OET adverse effects, and the likelihood of unmet decisional needs related to OET. CONCLUSIONS:: Adverse effects contribute to BCSs decisions to stop OET, yet there has been little investigation of the process through which that occurs. This review serves as a call to action for providers to provide support to BCSs experiencing OET adverse effects and facing decisions related to nonadherence. IMPLICATIONS FOR PRACTICE:: Findings suggest BCSs prescribed OET have unmet decisional needs, and more decisional supports are needed for BCSs experiencing OET adverse effects.

AB - BACKGROUND:: Oral endocrine therapy (OET) such as tamoxifen or aromatase inhibitors reduces recurrence and mortality for the 75% of breast cancer survivors (BCSs) with a diagnosis of estrogen receptor–positive breast cancer. Because many BCSs decide not take OET as recommended because of adverse effects, understanding BCSs’ decisional supports and needs is foundational to supporting quality OET decision making about whether to adhere to OET. OBJECTIVE:: The aim of this study was to examine literature pertaining to OET nonadherence and adverse effects using the Ottawa Decision Support Framework categories of decisional supports and decisional needs because these factors potentially influence OET use. METHODS:: A systematic literature search was performed in PubMed and CINAHL using combined search terms “aromatase inhibitors and adherence” and “tamoxifen and adherence.” Studies that did not meet criteria were excluded. Relevant data from 25 publications were extracted into tables and reviewed by 2 authors. RESULTS:: Findings identified the impact of adverse effects on OET nonadherence, an absence of decisional supports provided to or available for BCSs who are experiencing OET adverse effects, and the likelihood of unmet decisional needs related to OET. CONCLUSIONS:: Adverse effects contribute to BCSs decisions to stop OET, yet there has been little investigation of the process through which that occurs. This review serves as a call to action for providers to provide support to BCSs experiencing OET adverse effects and facing decisions related to nonadherence. IMPLICATIONS FOR PRACTICE:: Findings suggest BCSs prescribed OET have unmet decisional needs, and more decisional supports are needed for BCSs experiencing OET adverse effects.

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