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Beliefs About Medication and Uptake of Preventive Therapy in Women at Increased Risk of Breast Cancer: Results From a Multicenter Prospective Study

2018; Elsevier BV; Volume: 19; Issue: 1 Linguagem: Inglês

10.1016/j.clbc.2018.10.008

1938-0666

Rachael Thorneloe, Rob Horne, Lucy Side, Michael S. Wolf, Samuel G. Smith, Vanessa Adamson, Sarah Ainsworth, Malin Akerlund, Ivanna Baker, Julian Barwell, J. Beesley, Lisa Brock, Chrissie Butcher, Janice Carpenter, M. Diane Clark, Shirley Cocks, Veronica Conteh, Martina Coulding, Sue Darby, Angela Duckworth, D. Gareth Evans, Catherine Fensom, Julie Fletcher, Kate Foster, Sara Grieg, Elaine Gullaksen, Jana Gurasashvili, Lisa Hardstaff, Rachel Hart, Kathryn Hoare, Jonathan Hoffman, Christopher Holcombe, Lynne Horton, Anthony Howell, Farah Islam, Emma M. Jenkinson, Karen Jewers, Manisha Joshi, Amy Kirkby, Peter Kneeshaw, Natalie Knife, Jalal Kokan, Jin Li, Nicola Lunt, Douglas Macmillan, Karen Makinson, Evangelos Mallidis, Sarah Manyangadze, Charity Masvaure, Raksha Mistry, Alice Ngumo, Jane Ooi, Ashraf Patel, Vanessa Pope, Laura Price, Fiona Rabson, Lisa C. Richardson, Stephanie Ridgway, Karen Riley, Lorraine Roberts, Janet Ryan-Smith, Vian Salih, Nicky Scott, Mike Shere, Andrew Sloan, Nita Solanky, Amanda Taylor, Dinesh Thekkinkattil, Heather Thomas, Mangesh A. Thorat, Barbara Townley, Jayant S. Vaidya, Lynda Wagstaff, Shane Walsh, Lynsey Waring, Donna Watterson, Charlotte Westley, Lesley Wilkinson, Nicola Willis, Julia Wiseman,

Patient-Provider Communication in Healthcare

IntroductionUptake of preventive therapies for breast cancer is low. We examined whether women at increased risk of breast cancer can be categorized into groups with similar medication beliefs, and whether belief group membership was prospectively associated with uptake of preventive therapy.Patients and MethodsWomen (n = 732) attending an appointment to discuss breast cancer risk were approached; 408 (55.7%) completed the Beliefs About Medicines and the Perceived Sensitivity to Medicines questionnaires. Uptake of tamoxifen at 3 months was reported in 258 (63.2%). The optimal number of belief groups were identified using latent profile analysis.ResultsUptake of tamoxifen was 14.7% (38/258). One in 5 women (19.4%; 78/402) reported a strong need for tamoxifen. The model fit statistics supported a 2-group model. Both groups held weak beliefs about their need for tamoxifen for current and future health. Group 2 (38%; 154/406 of the sample) reported stronger concerns about tamoxifen and medicines in general, and stronger perceived sensitivity to the negative effects of medicines compared with group 1 (62%; 252/406). Women with low necessity and lower concerns (group 1) were more likely to initiate tamoxifen (18.3%; 33/180) than those with low necessity and higher concerns (group 2) (6.4%; 5/78). After adjusting for demographic and clinical factors, the odds ratio was 3.37 (95% confidence interval, 1.08-10.51; P = .036).ConclusionUptake of breast cancer preventive therapy was low. A subgroup of women reported low need for preventive therapy and strong medication concerns. These women were less likely to initiate tamoxifen. Medication beliefs are targets for supporting informed decision-making.