Association between self-report adherence measures and oestrogen suppression among breast cancer survivors on aromatase inhibitors

作者：Brier Moriah J; Chambless Dianne; Gross Robert; Su H Irene; DeMichele Angela; Mao Jun J^*

来源：European Journal of Cancer, 2015, 51(14): 1890-1896.

DOI：10.1016/j.ejca.2015.06.113

• Aromatase inhibitors
• Breast neoplasms
• Medication adherence
• Self-report

Purpose: Poor adherence to oral adjuvant hormonal therapy for breast cancer is a common problem, but little is known about the relationship between self-report adherence measures and hormonal suppression. We evaluated the relationship of three self-report measures of medication adherence and oestrogen among patients on aromatase inhibitors (AIs).
Materials and methods: We recruited 235 women with breast cancer who were prescribed AI therapy. Participants self-reported AI adherence by completing the following: (1) a single item asking whether they took an AI in the last month, (2) a modified Morisky Medication Adherence Scale-8 (MMAS-8) and (3) the Visual Analog Scale (VAS). Serum estrone and estradiol were analysed using organic solvent extraction and Celite column partition chromatography, followed by radioimmunoassay.
Results: Ten percent of participants reported they had not taken an AI in the last month and among this group, median estrone (33.2 pg/ml [interquartile range (IQR) = 22.3]) and estradiol levels (7.2 pg/mL [IQR = 3.3]) were significantly higher than those in participants who reported AI use (median estrone = 11.5 pg/mL [IQR = 4.9]; median estradiol = 3.4 pg/mL [IQR = 2.1]; p < 0.001). This relationship held when controlling for race and AI drug type.
Conclusions: A single-item monthly-recall adherence measure for AIs was associated with oestrogen serum levels. This suggests that patient-reported monthly adherence may be a useful measure to identify early non-adherence behaviour and guide interventions to improve patient adherence to hormonal treatment.

• 出版日期2015-9