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.	劉宗超, 李哲軒, 張陽, 等. 2020全球癌癥統計報告解讀. 腫瘤綜合治療電子雜志, 2021, 7(2): 1-13.
3.	趙健潔, 張曉華, 郝帥, 等. 雌激素受體陽性乳腺癌內分泌治療療效預測標志物研究進展. 重慶醫科大學學報, 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.	中華人民共和國國家衛生健康委員會. 乳腺癌診療指南(2022年版). 中國合理用藥探索, 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.	孫正魁, 江澤飛. 2022版《中國臨床腫瘤學會乳腺癌診療指南》更新解讀. 中國腫瘤外科雜志, 2022, 14(3): 212-218.
11.	周英鳳, 顧鶯, 胡雁, 等. JBI循證衛生保健中心對關于不同類型研究的質量評價工具——患病率及分析性橫斷面研究的質量評價. 護士進修雜志, 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.	朱葉卉, 黃嘉玲, 胡雁, 等. 乳腺癌患者內分泌治療的服藥依從性研究. 護理學雜志, 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.	張俊. 呂梁市某三甲醫院乳腺癌患者內分泌治療服藥依從性現況調查分析. 中國保健營養, 2020, 30(35): 4.
16.	王靜雅, 王惠仙, 王凌. 乳腺癌術后患者內分泌治療依從性及影響因素調查與分析. 護理與康復, 2013, 12(6): 525-527.
17.	姚曉冬, 林哲瑩. 105例乳腺癌輔助內分泌治療依從性分析. 國際醫藥衛生導報, 2014, 20(10): 1425-1428.
18.	宋玫瑰, 梁英. 乳腺癌術后患者內分泌治療依從性的調查及分析. 腫瘤預防與治療, 2014, (3): 141-144.
19.	李麗, 秦建偉, 韋達, 等. 乳腺癌內分泌治療依從性研究. 中華內分泌外科雜志, 2014, 8(5): 359-361.
20.	郭曄, 郭廣香, 隗和紅, 等. 乳腺癌內分泌治療的依從性研究及影響因素分析. 中國民康醫學, 2014, (15): 33-36.
21.	杜娟, 趙秀莉, 張文周. 280例乳腺癌患者內分泌治療用藥依從性分析. 中國藥房, 2016, 27(26): 3718-3720.
22.	杜玲. 接受內分泌治療的乳腺癌患者服藥依從性的影響因素探討. 中外醫學研究, 2017, 15(32): 41-42.
23.	吳紹勇, 彭星辰, 冉啟志. Luminal型乳腺癌患者內分泌藥物治療依從性的影響因素分析. 中國藥房, 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. 乳腺癌患者內分泌治療依從性的影響因素分析. 實用預防醫學, 2020, 27(10): 1229-1232.
27.	閆靜, 葛曉麗. 激素受體陽性乳腺癌患者術后內分泌治療依存性影響因素分析及護理對策. 中國藥物與臨床, 2020, 20(9): 1574-1576.
28.	李發榮, 張志業, 楊艷麗, 等. 乳腺癌患者內分泌治療依從性的影響因素研究. 寧夏醫學雜志, 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. 乳腺癌內分泌治療依從性分析. 烏魯木齊: 新疆醫科大學, 2013.
32.	宋濤. 絕經前乳腺癌患者內分泌治療依從性的調查和影響因素分析. 石家莊: 河北醫科大學, 2017.
33.	楊穎. 保定市激素受體陽性乳腺癌患者輔助內分泌治療依從性及其影響因素調查. 石家莊: 河北醫科大學, 2017.
34.	王旭. 絕經后乳腺癌患者內分泌治療依從性研究. 石家莊: 河北醫科大學, 2017.
35.	金晶. 激素受體陽性乳腺癌患者輔助內分泌治療依從性現狀分析. 濟南: 山東大學, 2019.
36.	鄧贏芳. 乳腺癌患者輔助內分泌治療依從性研究. 西寧: 青海大學, 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.	許日祥, 沐婷玉, 倪曉莉, 等. 中國高血壓患者用藥依從性的meta分析. 中國現代應用藥學, 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. 劉宗超, 李哲軒, 張陽, 等. 2020全球癌癥統計報告解讀. 腫瘤綜合治療電子雜志, 2021, 7(2): 1-13.
3. 趙健潔, 張曉華, 郝帥, 等. 雌激素受體陽性乳腺癌內分泌治療療效預測標志物研究進展. 重慶醫科大學學報, 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. 中華人民共和國國家衛生健康委員會. 乳腺癌診療指南(2022年版). 中國合理用藥探索, 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. 孫正魁, 江澤飛. 2022版《中國臨床腫瘤學會乳腺癌診療指南》更新解讀. 中國腫瘤外科雜志, 2022, 14(3): 212-218.
11. 周英鳳, 顧鶯, 胡雁, 等. JBI循證衛生保健中心對關于不同類型研究的質量評價工具——患病率及分析性橫斷面研究的質量評價. 護士進修雜志, 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. 朱葉卉, 黃嘉玲, 胡雁, 等. 乳腺癌患者內分泌治療的服藥依從性研究. 護理學雜志, 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. 張俊. 呂梁市某三甲醫院乳腺癌患者內分泌治療服藥依從性現況調查分析. 中國保健營養, 2020, 30(35): 4.
16. 王靜雅, 王惠仙, 王凌. 乳腺癌術后患者內分泌治療依從性及影響因素調查與分析. 護理與康復, 2013, 12(6): 525-527.
17. 姚曉冬, 林哲瑩. 105例乳腺癌輔助內分泌治療依從性分析. 國際醫藥衛生導報, 2014, 20(10): 1425-1428.
18. 宋玫瑰, 梁英. 乳腺癌術后患者內分泌治療依從性的調查及分析. 腫瘤預防與治療, 2014, (3): 141-144.
19. 李麗, 秦建偉, 韋達, 等. 乳腺癌內分泌治療依從性研究. 中華內分泌外科雜志, 2014, 8(5): 359-361.
20. 郭曄, 郭廣香, 隗和紅, 等. 乳腺癌內分泌治療的依從性研究及影響因素分析. 中國民康醫學, 2014, (15): 33-36.
21. 杜娟, 趙秀莉, 張文周. 280例乳腺癌患者內分泌治療用藥依從性分析. 中國藥房, 2016, 27(26): 3718-3720.
22. 杜玲. 接受內分泌治療的乳腺癌患者服藥依從性的影響因素探討. 中外醫學研究, 2017, 15(32): 41-42.
23. 吳紹勇, 彭星辰, 冉啟志. Luminal型乳腺癌患者內分泌藥物治療依從性的影響因素分析. 中國藥房, 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. 乳腺癌患者內分泌治療依從性的影響因素分析. 實用預防醫學, 2020, 27(10): 1229-1232.
27. 閆靜, 葛曉麗. 激素受體陽性乳腺癌患者術后內分泌治療依存性影響因素分析及護理對策. 中國藥物與臨床, 2020, 20(9): 1574-1576.
28. 李發榮, 張志業, 楊艷麗, 等. 乳腺癌患者內分泌治療依從性的影響因素研究. 寧夏醫學雜志, 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. 乳腺癌內分泌治療依從性分析. 烏魯木齊: 新疆醫科大學, 2013.
32. 宋濤. 絕經前乳腺癌患者內分泌治療依從性的調查和影響因素分析. 石家莊: 河北醫科大學, 2017.
33. 楊穎. 保定市激素受體陽性乳腺癌患者輔助內分泌治療依從性及其影響因素調查. 石家莊: 河北醫科大學, 2017.
34. 王旭. 絕經后乳腺癌患者內分泌治療依從性研究. 石家莊: 河北醫科大學, 2017.
35. 金晶. 激素受體陽性乳腺癌患者輔助內分泌治療依從性現狀分析. 濟南: 山東大學, 2019.
36. 鄧贏芳. 乳腺癌患者輔助內分泌治療依從性研究. 西寧: 青海大學, 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. 許日祥, 沐婷玉, 倪曉莉, 等. 中國高血壓患者用藥依從性的meta分析. 中國現代應用藥學, 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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