by Leanne Fleming, Sommer Agnew, Nicola Peddie, Megan
Crawford, Diane Dixon, Iain MacPherson
The Breast: VOLUME 64, P63-84, AUGUST 01,
2022 (Published: May 13, 2022)
Background
Hormone Therapy (HT) is recommended for most women with
HR-positive primary breast cancer. When taken as intended, HT reduces breast
cancer recurrence by 40% and mortality by one-third. The recommended duration
of treatment ranges from 5 to 10 years depending on risk of recurrence and the
specific HT regimen. However, recent data indicates that rates of HT
non-adherence are high and research suggests this may be due to the impact of
HT side effects. The contribution of side effects to non-adherence and non-persistence
behaviours has rarely been systematically explored, thereby hindering the
implementation of targeted intervention strategies. Our aim is to identify,
evaluate and summarise the relationship between HT side effects and patterns of
adherence and persistence.
Methods
Electronic searches were conducted from inception and were
completed by September 2021, utilising Cochrane CENTRAL, Medline, Embase, Web
of Science and PsycINFO databases. Searches included a combination of terms
related to breast cancer, adherence, hormone therapy and side effects.
Results
Sixty-two eligible papers were identified and study quality
varied by study type. Most observational and cross-sectional studies were rated
good quality, whereas most controlled intervention studies were rated fair
quality. Three studies were rated poor quality. The most frequently measured
side effects were pain, low mood, hot flashes, insomnia, anxiety, fatigue,
weight gain, concentration/memory problems.
Conclusions
This review identified a lack of consistency in the
measurement of adherence and the definition of persistence across studies. The
instruments used to measure side effects also varied significantly. This
variation and lack of consistency makes it difficult to evaluate and summarise
the role of HT side effects in HT adherence and persistence behaviour.
