Adjuvant endocrine therapy adherence among Chinese patients with breast cancer: a systematic review_Chinese Journal of Evidence-Based Medicine

Authors：

WANG Lijie ¹ , LIU Jiahui ² ,  LI Xuying ^3,4 , PENG Siyi ⁵ , HU Meihua ³ , CHEN Jiejun ² , MENG Lingqi ¹

1. The Xiang Ya nursing school of Central south university, Changsha 410013, P. R. China;
2. Department of Breast Medicine, the Hunan Cancer Hospital, Changsha 410013, P. R. China;
3. Department of Nursing, the Hunan Cancer Hospital, Changsha 410013, P. R. China;
4. The Xiangya Evidence-based Practice and Health Innovation Center: JBI Collaboration Group, Changsha 410013, P. R. China;
5. Department of Early Clinical Research Center, the Hunan Cancer Hospital, Changsha 410013, P. R. China;

Corresponding author：

LI Xuying, Email: 1259734926@qq.com

Keywords：

Breast cancer; Adjuvant endocrine therapy; Adherence; Systematic review; Meta-analysis

DOI：

10.7507/1672-2531.202210101

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To systematically review the adjuvant endocrine therapy adherence among Chinese patients with breast cancer. Methods The Cochrane Library, Web of Science, PubMed, EMbase, CINAHL, CNKI, VIP, WanFang Data and CBM were electronically searched to collect studies on adjuvant endocrine therapy adherence among Chinese patients with breast cancer from inception to September 2022. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then, meta-analysis was performed by using Stata 16.0 software. Results A total of 24 studies were included. The results of meta-analysis showed that: the overall adherence rate of adjuvant endocrine therapy in Chinese breast cancer patients was 55.0% (95%CI 0.44 to 0.65), and a 5-year adherence rate was 54.4% (95%CI 0.46 to 0.63). Subgroup analysis showed that patients with good disease awareness, high education level, high monthly household income, living in cities, effective family support, no adverse drug reactions, high convenience of seeking medical treatment, regular review, health education, no comorbidities, and changes in medication type might have higher compliance. Conclusion The adherence rate of adjuvant endocrine therapy in breast cancer patients in China is low. Adherence varies between sociodemographic characteristics, treatment, and social support for breast cancer patients.

Citation： WANG Lijie, LIU Jiahui, LI Xuying, PENG Siyi, HU Meihua, CHEN Jiejun, MENG Lingqi. Adjuvant endocrine therapy adherence among Chinese patients with breast cancer: a systematic review. Chinese Journal of Evidence-Based Medicine, 2023, 23(2): 153-158. doi: 10.7507/1672-2531.202210101 Copy

1.	Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2021, 71(3): 209-249.
2.	刘宗超, 李哲轩, 张阳, 等. 2020全球癌症统计报告解读. 肿瘤综合治疗电子杂志, 2021, 7(2): 1-13.
3.	赵健洁, 张晓华, 郝帅, 等. 雌激素受体阳性乳腺癌内分泌治疗疗效预测标志物研究进展. 重庆医科大学学报, 2019, 44(12): 1542-1546.
4.	National Comprehensive Cancer Network. NCCN guidelines: breast cancer version 4.2022, 2022-6-21. Available at: https://nccn.medlive.cn/guide/detail/149.
5.	中华人民共和国国家卫生健康委员会. 乳腺癌诊疗指南(2022年版). 中国合理用药探索, 2022, 19(10): 1-26.
6.	Moon Z, Moss-Morris R, Hunter MS, et al. Barriers and facilitators of adjuvant hormone therapy adherence and persistence in women with breast cancer: a systematic review. Patient Prefer Adherence, 2017, 11: 305-322.
7.	WHO. Adherence to long-term therapies: evidence for action. Geneva: World Health Organization, 2003.
8.	Markkula A, Hietala M, Henningson M, et al. Clinical profiles predict early nonadherence to adjuvant endocrine treatment in a prospective breast cancer cohort. Cancer Prev Res (Phila), 2012, 5(5): 735-745.
9.	Yood MU, Owusu C, Buist DS, et al. Mortality impact of less-than-standard therapy in older breast cancer patients. J Am Coll Surg, 2008, 206(1): 66-75.
10.	孙正魁, 江泽飞. 2022版《中国临床肿瘤学会乳腺癌诊疗指南》更新解读. 中国肿瘤外科杂志, 2022, 14(3): 212-218.
11.	周英凤, 顾莺, 胡雁, 等. JBI循证卫生保健中心对关于不同类型研究的质量评价工具——患病率及分析性横断面研究的质量评价. 护士进修杂志, 2018, 33(3): 219-221.
12.	Stang A. Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol, 2010, 25(9): 603-605.
13.	朱叶卉, 黄嘉玲, 胡雁, 等. 乳腺癌患者内分泌治疗的服药依从性研究. 护理学杂志, 2013, 28(16): 43-45.
14.	Hsieh KP, Chen LC, Cheung KL, et al. Risks of nonadherence to hormone therapy in Asian women with breast cancer. Kaohsiung J Med Sci, 2015, 31(6): 328-334.
15.	张俊. 吕梁市某三甲医院乳腺癌患者内分泌治疗服药依从性现况调查分析. 中国保健营养, 2020, 30(35): 4.
16.	王静雅, 王惠仙, 王凌. 乳腺癌术后患者内分泌治疗依从性及影响因素调查与分析. 护理与康复, 2013, 12(6): 525-527.
17.	姚晓冬, 林哲莹. 105例乳腺癌辅助内分泌治疗依从性分析. 国际医药卫生导报, 2014, 20(10): 1425-1428.
18.	宋玫瑰, 梁英. 乳腺癌术后患者内分泌治疗依从性的调查及分析. 肿瘤预防与治疗, 2014, (3): 141-144.
19.	李丽, 秦建伟, 韦达, 等. 乳腺癌内分泌治疗依从性研究. 中华内分泌外科杂志, 2014, 8(5): 359-361.
20.	郭晔, 郭广香, 隗和红, 等. 乳腺癌内分泌治疗的依从性研究及影响因素分析. 中国民康医学, 2014, (15): 33-36.
21.	杜娟, 赵秀莉, 张文周. 280例乳腺癌患者内分泌治疗用药依从性分析. 中国药房, 2016, 27(26): 3718-3720.
22.	杜玲. 接受内分泌治疗的乳腺癌患者服药依从性的影响因素探讨. 中外医学研究, 2017, 15(32): 41-42.
23.	吴绍勇, 彭星辰, 冉启志. Luminal型乳腺癌患者内分泌药物治疗依从性的影响因素分析. 中国药房, 2018, 29(18): 2528-2531.
24.	Gao P, You L, Wu D, et al. Adherence to endocrine therapy among Chinese patients with breast cancer: current status and recommendations for improvement. Patient Prefer Adherence, 2018, 12: 887-897.
25.	Mao F, Zhang YN, Zhao JL, et al. An investigative study of factors affecting breast cancer patients' preference of extended endocrine therapy. Trans Can Res, 2018, 7(1): 189-196.
26.	廖瑜玲. 乳腺癌患者内分泌治疗依从性的影响因素分析. 实用预防医学, 2020, 27(10): 1229-1232.
27.	闫静, 葛晓丽. 激素受体阳性乳腺癌患者术后内分泌治疗依存性影响因素分析及护理对策. 中国药物与临床, 2020, 20(9): 1574-1576.
28.	李发荣, 张志业, 杨艳丽, 等. 乳腺癌患者内分泌治疗依从性的影响因素研究. 宁夏医学杂志, 2020, 42(4): 378-380.
29.	Xu H, Jin F, Zhang XJ, et al. Adherence status to adjuvant endocrine therapy in Chinese women with early breast cancer and its influencing factors: a cross-sectional survey. Cancer Med, 2020, 9(11): 3703-3713.
30.	Jiang H, Dong Y, Zong W, et al. The relationship among psychosocial adaptation, medication adherence and quality of life in breast cancer women with adjuvant endocrine therapy. BMC Womens Health, 2022, 22(1): 135.
31.	郝永杰. 乳腺癌内分泌治疗依从性分析. 乌鲁木齐: 新疆医科大学, 2013.
32.	宋涛. 绝经前乳腺癌患者内分泌治疗依从性的调查和影响因素分析. 石家庄: 河北医科大学, 2017.
33.	杨颖. 保定市激素受体阳性乳腺癌患者辅助内分泌治疗依从性及其影响因素调查. 石家庄: 河北医科大学, 2017.
34.	王旭. 绝经后乳腺癌患者内分泌治疗依从性研究. 石家庄: 河北医科大学, 2017.
35.	金晶. 激素受体阳性乳腺癌患者辅助内分泌治疗依从性现状分析. 济南: 山东大学, 2019.
36.	邓赢芳. 乳腺癌患者辅助内分泌治疗依从性研究. 西宁: 青海大学, 2020.
37.	Yussof I, Mohd Tahir NA, Hatah E, et al. Factors influencing five-year adherence to adjuvant endocrine therapy in breast cancer patients: A systematic review. Breast, 2022, 62: 22-35.
38.	Heiney SP, Truman S, Babatunde OA, et al. Racial and geographic disparities in endocrine therapy adherence among younger breast cancer survivors. Am J Clin Oncol, 2020, 43(7): 504-509.
39.	Guedes JBR, Guerra MR, Alvim MM, et al. Factors associated with adherence and persistence to hormonal therapy in women with breast cancer. Rev Bras Epidemiol, 2017, 20(4): 636-649.
40.	Mir O, Ferrua M, Fourcade A, et al. Digital remote monitoring plus usual care versus usual care in patients treated with oral anticancer agents: the randomized phase 3 CAPRI trial. Nat Med, 2022, 28(6): 1224-1231.
41.	Wen KY. Not just another app: realizing the potential of mobile healthcare applications to promote adherence to oral cancer therapy medications. J Natl Compr Canc Netw, 2020, 18(2): 219-220.
42.	许日祥, 沐婷玉, 倪晓莉, 等. 中国高血压患者用药依从性的meta分析. 中国现代应用药学, 2020, 37(19): 2383-2389.
43.	Ruhstaller T, Giobbie-Hurder A, Colleoni M, et al. Adjuvant letrozole and tamoxifen alone or sequentially for postmenopausal women with hormone receptor-positive breast cancer: long-term follow-up of the BIG 1-98 trial. J Clin Oncol, 2019, 37(2): 105-114.
44.	Buzdar AU, Coombes RC, Goss PE, et al. Summary of aromatase inhibitor clinical trials in postmenopausal women with early breast cancer. Cancer, 2008, 112(3 Suppl): 700-709.
45.	Pistilli B, Paci A, Ferreira AR, et al. Serum detection of nonadherence to adjuvant tamoxifen and breast cancer recurrence risk. J Clin Oncol, 2020, 38(24): 2762-2772.
46.	AlOmeir O, Patel N, Donyai P. Adherence to adjuvant endocrine therapy among breast cancer survivors: a systematic review and meta-synthesis of the qualitative literature using grounded theory. Support Care Cancer, 2020, 28(11): 5075-5084.
47.	Clancy C, Lynch J, OConnor P, et al. Breast cancer patients' experiences of adherence and persistence to oral endocrine therapy: A qualitative evidence synthesis. Eur J Oncol Nurs, 2020, 44: 101706.
48.	Xu H, Zhang XJ, Wang DQ, et al. Factors influencing medication-taking behaviour with adjuvant endocrine therapy in women with breast cancer: A qualitative systematic review. J Adv Nurs, 2020, 76(2): 445-458.
49.	Lundgren C, Lindman H, Rolander B, et al. Good adherence to adjuvant endocrine therapy in early breast cancer - a population-based study based on the Swedish prescribed drug register. Acta Oncol, 2018, 57(7): 935-940.

1. Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2021, 71(3): 209-249.
2. 刘宗超, 李哲轩, 张阳, 等. 2020全球癌症统计报告解读. 肿瘤综合治疗电子杂志, 2021, 7(2): 1-13.
3. 赵健洁, 张晓华, 郝帅, 等. 雌激素受体阳性乳腺癌内分泌治疗疗效预测标志物研究进展. 重庆医科大学学报, 2019, 44(12): 1542-1546.
4. National Comprehensive Cancer Network. NCCN guidelines: breast cancer version 4.2022, 2022-6-21. Available at: https://nccn.medlive.cn/guide/detail/149.
5. 中华人民共和国国家卫生健康委员会. 乳腺癌诊疗指南(2022年版). 中国合理用药探索, 2022, 19(10): 1-26.
6. Moon Z, Moss-Morris R, Hunter MS, et al. Barriers and facilitators of adjuvant hormone therapy adherence and persistence in women with breast cancer: a systematic review. Patient Prefer Adherence, 2017, 11: 305-322.
7. WHO. Adherence to long-term therapies: evidence for action. Geneva: World Health Organization, 2003.
8. Markkula A, Hietala M, Henningson M, et al. Clinical profiles predict early nonadherence to adjuvant endocrine treatment in a prospective breast cancer cohort. Cancer Prev Res (Phila), 2012, 5(5): 735-745.
9. Yood MU, Owusu C, Buist DS, et al. Mortality impact of less-than-standard therapy in older breast cancer patients. J Am Coll Surg, 2008, 206(1): 66-75.
10. 孙正魁, 江泽飞. 2022版《中国临床肿瘤学会乳腺癌诊疗指南》更新解读. 中国肿瘤外科杂志, 2022, 14(3): 212-218.
11. 周英凤, 顾莺, 胡雁, 等. JBI循证卫生保健中心对关于不同类型研究的质量评价工具——患病率及分析性横断面研究的质量评价. 护士进修杂志, 2018, 33(3): 219-221.
12. Stang A. Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol, 2010, 25(9): 603-605.
13. 朱叶卉, 黄嘉玲, 胡雁, 等. 乳腺癌患者内分泌治疗的服药依从性研究. 护理学杂志, 2013, 28(16): 43-45.
14. Hsieh KP, Chen LC, Cheung KL, et al. Risks of nonadherence to hormone therapy in Asian women with breast cancer. Kaohsiung J Med Sci, 2015, 31(6): 328-334.
15. 张俊. 吕梁市某三甲医院乳腺癌患者内分泌治疗服药依从性现况调查分析. 中国保健营养, 2020, 30(35): 4.
16. 王静雅, 王惠仙, 王凌. 乳腺癌术后患者内分泌治疗依从性及影响因素调查与分析. 护理与康复, 2013, 12(6): 525-527.
17. 姚晓冬, 林哲莹. 105例乳腺癌辅助内分泌治疗依从性分析. 国际医药卫生导报, 2014, 20(10): 1425-1428.
18. 宋玫瑰, 梁英. 乳腺癌术后患者内分泌治疗依从性的调查及分析. 肿瘤预防与治疗, 2014, (3): 141-144.
19. 李丽, 秦建伟, 韦达, 等. 乳腺癌内分泌治疗依从性研究. 中华内分泌外科杂志, 2014, 8(5): 359-361.
20. 郭晔, 郭广香, 隗和红, 等. 乳腺癌内分泌治疗的依从性研究及影响因素分析. 中国民康医学, 2014, (15): 33-36.
21. 杜娟, 赵秀莉, 张文周. 280例乳腺癌患者内分泌治疗用药依从性分析. 中国药房, 2016, 27(26): 3718-3720.
22. 杜玲. 接受内分泌治疗的乳腺癌患者服药依从性的影响因素探讨. 中外医学研究, 2017, 15(32): 41-42.
23. 吴绍勇, 彭星辰, 冉启志. Luminal型乳腺癌患者内分泌药物治疗依从性的影响因素分析. 中国药房, 2018, 29(18): 2528-2531.
24. Gao P, You L, Wu D, et al. Adherence to endocrine therapy among Chinese patients with breast cancer: current status and recommendations for improvement. Patient Prefer Adherence, 2018, 12: 887-897.
25. Mao F, Zhang YN, Zhao JL, et al. An investigative study of factors affecting breast cancer patients' preference of extended endocrine therapy. Trans Can Res, 2018, 7(1): 189-196.
26. 廖瑜玲. 乳腺癌患者内分泌治疗依从性的影响因素分析. 实用预防医学, 2020, 27(10): 1229-1232.
27. 闫静, 葛晓丽. 激素受体阳性乳腺癌患者术后内分泌治疗依存性影响因素分析及护理对策. 中国药物与临床, 2020, 20(9): 1574-1576.
28. 李发荣, 张志业, 杨艳丽, 等. 乳腺癌患者内分泌治疗依从性的影响因素研究. 宁夏医学杂志, 2020, 42(4): 378-380.
29. Xu H, Jin F, Zhang XJ, et al. Adherence status to adjuvant endocrine therapy in Chinese women with early breast cancer and its influencing factors: a cross-sectional survey. Cancer Med, 2020, 9(11): 3703-3713.
30. Jiang H, Dong Y, Zong W, et al. The relationship among psychosocial adaptation, medication adherence and quality of life in breast cancer women with adjuvant endocrine therapy. BMC Womens Health, 2022, 22(1): 135.
31. 郝永杰. 乳腺癌内分泌治疗依从性分析. 乌鲁木齐: 新疆医科大学, 2013.
32. 宋涛. 绝经前乳腺癌患者内分泌治疗依从性的调查和影响因素分析. 石家庄: 河北医科大学, 2017.
33. 杨颖. 保定市激素受体阳性乳腺癌患者辅助内分泌治疗依从性及其影响因素调查. 石家庄: 河北医科大学, 2017.
34. 王旭. 绝经后乳腺癌患者内分泌治疗依从性研究. 石家庄: 河北医科大学, 2017.
35. 金晶. 激素受体阳性乳腺癌患者辅助内分泌治疗依从性现状分析. 济南: 山东大学, 2019.
36. 邓赢芳. 乳腺癌患者辅助内分泌治疗依从性研究. 西宁: 青海大学, 2020.
37. Yussof I, Mohd Tahir NA, Hatah E, et al. Factors influencing five-year adherence to adjuvant endocrine therapy in breast cancer patients: A systematic review. Breast, 2022, 62: 22-35.
38. Heiney SP, Truman S, Babatunde OA, et al. Racial and geographic disparities in endocrine therapy adherence among younger breast cancer survivors. Am J Clin Oncol, 2020, 43(7): 504-509.
39. Guedes JBR, Guerra MR, Alvim MM, et al. Factors associated with adherence and persistence to hormonal therapy in women with breast cancer. Rev Bras Epidemiol, 2017, 20(4): 636-649.
40. Mir O, Ferrua M, Fourcade A, et al. Digital remote monitoring plus usual care versus usual care in patients treated with oral anticancer agents: the randomized phase 3 CAPRI trial. Nat Med, 2022, 28(6): 1224-1231.
41. Wen KY. Not just another app: realizing the potential of mobile healthcare applications to promote adherence to oral cancer therapy medications. J Natl Compr Canc Netw, 2020, 18(2): 219-220.
42. 许日祥, 沐婷玉, 倪晓莉, 等. 中国高血压患者用药依从性的meta分析. 中国现代应用药学, 2020, 37(19): 2383-2389.
43. Ruhstaller T, Giobbie-Hurder A, Colleoni M, et al. Adjuvant letrozole and tamoxifen alone or sequentially for postmenopausal women with hormone receptor-positive breast cancer: long-term follow-up of the BIG 1-98 trial. J Clin Oncol, 2019, 37(2): 105-114.
44. Buzdar AU, Coombes RC, Goss PE, et al. Summary of aromatase inhibitor clinical trials in postmenopausal women with early breast cancer. Cancer, 2008, 112(3 Suppl): 700-709.
45. Pistilli B, Paci A, Ferreira AR, et al. Serum detection of nonadherence to adjuvant tamoxifen and breast cancer recurrence risk. J Clin Oncol, 2020, 38(24): 2762-2772.
46. AlOmeir O, Patel N, Donyai P. Adherence to adjuvant endocrine therapy among breast cancer survivors: a systematic review and meta-synthesis of the qualitative literature using grounded theory. Support Care Cancer, 2020, 28(11): 5075-5084.
47. Clancy C, Lynch J, OConnor P, et al. Breast cancer patients' experiences of adherence and persistence to oral endocrine therapy: A qualitative evidence synthesis. Eur J Oncol Nurs, 2020, 44: 101706.
48. Xu H, Zhang XJ, Wang DQ, et al. Factors influencing medication-taking behaviour with adjuvant endocrine therapy in women with breast cancer: A qualitative systematic review. J Adv Nurs, 2020, 76(2): 445-458.
49. Lundgren C, Lindman H, Rolander B, et al. Good adherence to adjuvant endocrine therapy in early breast cancer - a population-based study based on the Swedish prescribed drug register. Acta Oncol, 2018, 57(7): 935-940.

Chinese Journal of Evidence-Based Medicine

Adjuvant endocrine therapy adherence among Chinese patients with breast cancer: a systematic review

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