Aromatase inhibitors: assessment of knowledge, adherence, and associated factors among Iraqi women with breast cancer
DOI:
https://doi.org/10.60988/p.v37i2S.189Keywords:
breast cancer; aromatase inhibitors; knowledge; beliefs; adherenceAbstract
Adherence to aromatase inhibitors (AIs) as oral anticancer therapy remains a significant challenge in the management of hormone receptor-positive breast cancer. Despite their proven efficacy in reducing disease recurrence, many patients struggle to maintain long-term adherence. This study aimed at evaluating the patients’ knowledge and beliefs regarding AIs and their influence on non-adherence. An observational cross-sectional study was conducted in order to assess adherence and its association with patients’ beliefs, knowledge, and sociodemographic and clinical characteristics. Eligible breast cancer patients receiving AIs (either anastrozole or letrozole) on a monthly basis at the Babylon Oncology Center were recruited between 18 February and 1 October 2024 (N=70). Validated, tailored questionnaires were administered through structured interviews. The mean age of the participants was 56.1 ± 9.6 years. With respect to educational attainment, 48.6% had completed primary school, 25.7% had attained secondary education, 12.9% were illiterate, and 12.9% held a bachelor’s degree. Most patients (98.6%) were married. A majority (62.9%) resided in rural areas, while 37.1% lived in urban settings. Adherence showed a strong positive correlation with the patients’ knowledge of AIs (R=0.638, p<0.001). It was also positively associated with the perceived necessity of therapy (R=0.64, p=0.025), and negatively associated with concerns regarding adverse effects (R=-0.74, p<0.001). These findings suggest that breast cancer patients who exhibit greater awareness and a stronger sense of personal responsibility toward their treatment regimen are more likely to adhere to AI therapy. The study underscores the importance of addressing both perceived benefits and concerns in order to enhance adherence outcomes.
References
1. ElBaghdady N.S., El Gazzar M.M., Abdo A.M., Magdy A.M., Youssef F.A., Sayed K.A., et al. Adherence to oral hormonal treatment among breast cancer patients in Egypt. Asian Pac. J. Cancer Prev. 25(10), 3619–3625, 2024. DOI: 10.31557/APJCP.2024.25.10.3619
2. Talens A., Guilabert M., Lumbreras B., Aznar M.T., López-Pintor E. Medication experience and adherence to oral chemotherapy: a qualitative study of patients’ and health professionals’ perspectives. Int. J. Environ. Res. Public Health 18(8), 4266, 2021. DOI: 10.3390/ijerph18084266
3. V R., Chacko A.M., Abdulla N., Annamalai M., Kandi V. Medication adherence in cancer patients: a comprehensive review. Cureus 16(1), e52721, 2024. DOI: 10.7759/cureus.52721
4. Naeemah G.H., Ameen A.A.H. Assessment of adherence to National Comprehensive Cancer Network guideline recommended anticoagulant therapy in the management of patients with cancer-associated venous thromboembolic disease. Maaen J. Med. Sci. 2(3), 90–99, 2023. DOI: 10.55810/2789-9136.1025
5. Saad A.H., Rabeea I.S., Salih H.N. Adherence and beliefs to adjuvant hormonal therapy in patients with breast cancer: a cross-sectional study (conference paper). Iraqi J. Pharm. Sci. 30(s), 31–39, 2022. DOI: 10.31351/vol30issSuppl.pp31-39
6. Horne R., Weinman J. Patients’ beliefs about prescribed medicines and their role in adherence to treatment in chronic physical illness. J. Psychosom. Res. 47(6), 555–567, 1999. DOI: 10.1016/s0022-3999(99)00057-4
7. Milata J.L., Otte J.L., Carpenter J.S. Oral endocrine therapy nonadherence, adverse effects, decisional support, and decisional needs in women with breast cancer. Cancer Nurs. 41(1), E9–E18, 2018. DOI: 10.1097/NCC.0000000000000430
8. Lin M., Hackenyos D., Savidge N., Weidner R.A., Murphy-Banks R., Fleckner T., et al. Enhancing patients’ understanding of and adherence to oral anticancer medication: results of a longitudinal pilot intervention. J. Oncol. Pharm. Pract. 27(6), 1409–1421, 2021. DOI: 10.1177/1078155220960800
9. Oufi Z.S., Rabeea I.S. Assessing pharmacists’ knowledge of drugs’ dialyzability in four health institutions in Al-Najaf, Iraq. Maaen J. Med. Sci. 2(2), 66–72, 2023. DOI: 10.55810/2789-9136.1023
10. Green S.M.C., Smith S.G., Collins L.M., Strayhorn J.C. Decision-making in the multiphase optimization strategy: applying decision analysis for intervention value efficiency to optimize an information leaflet to promote key antecedents of medication adherence. Transl. Behav. Med. 14(8), 461–471, 2024. DOI: 10.1093/tbm/ibae029
