Factors associated with adherence and persistence to hormonal therapy in women with breast cancer
ABSTRACT: Introduction: Hormonal therapy in breast cancer is essential to the transition from active treatment to care survival, because it improves long-term survival and provides a better quality of life. reducing hospital costs as well. However, adherence and persistence in the recommended treatment are important to achieve the desirable results. Methodology: This is a cohort retrospective study of 182 women on hormonal treatment identified at a high complexity oncology unit, in the southeastern region of Brazil, and followed-up until 2014. We performed a bivariate analysis to analyze the factors associated with adherence and we conducted the multivariate Cox regression to identify variables associated with discontinuity of treatment over time. Results: Overall adherence was 85.2% and persistence was 45.4% at the end of 5 years. No association was found between the studied independent variables and adherence. Women with advanced stage (HR = 2.24; 95% confidence interval 1.45 - 3.45), who did not undergo surgery (HR = 3.46; 95%CI 2.00 - 5.97), and with three or more hospitalizations (HR = 6.06; 95%CI 2.53 - 14.54) exhibited increased risk of discontinuity. Discussion: The variables associated with persistence reflect the relation between the highest disease severity and the discontinuity of adjuvant hormonal treatment. Conclusion: Despite the high adherence level, there is a progressive increase in non-persistence among women on hormonal therapy, influenced by characteristics related to disease severity, which contributes to an inadequate therapeutic response.