Insight into barriers against optimal adherence to oral hormonal therapy in women with breast cancer

Background: Suboptimal adherence to prescribed oral anticancer agents has been demonstrated in several studies. Understanding the barriers to treatment compliance is becoming increasingly important because of the growing number of oral agents available to treat women with breast cancer. Patients and Methods: To identify barriers that affect patient adherence to oral hormonal medications, a self-reported, 30-question Internet survey was posted on the Y-ME National Breast Cancer Organization (TM) Web site, www.y-me.org, from June 30, 2005, through October 31, 2005. Of the 542 respondents who began the survey, 328 completed it. Results: Of those who answered the question related to whether healthcare professionals encouraged adherence, only 44.2% reported receiving instruction on the importance of taking oral medication as directed at every office visit. For 33%, the topic was reportedly discussed only once, and this occurred before treatment. Although 83.6% of patients indicated that they were taking their oral therapy as directed, only 57.4% rated their ability to adhere to therapy as excellent (not missing a single dose in the past month). The most frequently cited factors for increasing compliance to oral medications were knowing adherence could improve clinical outcomes (88.7%) and better management of treatment-related side effects (60.2%). Conclusion: The results of this survey suggest that treatment adherence could be improved if healthcare professionals discuss and emphasize (1) the importance of taking oral medications as directed and (2) the effect of adherence on clinical outcomes. Additional research is needed to evaluate the optimal methods for improving compliance with oral therapy.