Adherence to Adjuvant Hormonal Therapy and Associated Factors Among Women with Breast Cancer Attending the Tikur Anbessa Specialized Hospital, Addis Ababa Ethiopia, 2019: A Cross-sectional Study

Figures & data

Table 1 Sociodemographic Characteristics of Women with Breast Cancer Attending Oncology Center at TASH, Addis Ababa, Ethiopia, 2019 (N=209)

Variable	Frequency (N)	Percentage (%)
Age of respondent
<45	88	42.1
45–65	71	34.0
>65	50	23.9
Place of residence
Rural	88	42.1
Urban	121	57.9
Educational status
Unable to read and write	53	25.4
Primary education	53	25.4
High school and above	103	49.3
Marital status
Unmarried	55	26.3
Married	154	73.7
Religion
Orthodox	139	66.5
Muslim	38	18.2
Protestant	23	11.0
Others^a	9	4.3
Ethnicity
Amhara	82	39.7
Oromo	59	28.2
Gurage	32	15.3
Others^b	36	17.2
Occupation
Housewife	117	56.0
Private employee	21	10.0
Government employee	36	17.2
Others^c	35	16.7

Notes:^aCatholic, Adventist. ^bTigre, Silte, Gamo, Gofa, Wolayta, Anyuak. ^cStudent, merchant, labor worker, housemaid, retired, job seeker.

Table 2 Patient-related Variables of Women with Breast Cancer Attending Oncology Center at TASH, Addis Ababa, Ethiopia, 2019 (N=209)

Variable	Frequency (N)	Percentage (%)
Smoking
Yes	2	0.9
No	207	99.1
Alcohol
Yes	4	1.9
No	205	98.1
Social support
Yes	140	67.0
No	69	33.0

Table 3 Disease-related Variables of Women with Breast Cancer Attending Oncology Center at TASH, Addis Ababa, Ethiopia, 2019 (N=209)

Variable	Frequency (N)	Percentage (%)
Family history
Yes	19	9.1
No	190	90.9
Types of breast cancer
Ductal	187	89.5
Lobular	22	10.5
Stage
Early stage	58	27.8
Advanced stage	151	72.2
Menopausal status
Premenopause	66	31.6
Postmenopause	143	68.4
Hormone receptor status
Positive	23	11.0
Unknown	186	89.0
Laterality of the cancer
Unilateral	205	98.1
Bilateral	4	1.9
Radiotherapy
Yes	51	28.2
No	158	71.8
Chemotherapy
Yes	194	92.8
No	15	7.2
Surgery
Yes	188	90.0
No	21	10.0
Types of surgery
Mastectomy	189	90.4
Lumpectomy	20	9.6
Comorbidity
Yes	50	23.9
No	159	76.1
Comorbid illness
Diabetes mellitus	24	48
HIV/AIDS	12	24
Heart problem	8	16
Respiratory problem	6	12

Figure 1 Side effects of adjuvant hormonal therapy’s reported by the respondents among women with breast cancer attending oncology center at TASH, Addis Ababa, Ethiopia, 2019 (N=209).

Table 4 Medication-Related Variables of Women with Breast Cancer Attending Oncology Center at TASH, Addis Ababa, Ethiopia, 2019 (N=209)

Variable	Frequency (N)	Percentage (%)
Types of adjuvant hormonal therapy
Tamoxifen	118	56.5
Anastrozole	91	43.5
Year of initiation
2015	36	17.2
2016	24	11.5
2017	29	13.9
2018	58	27.7
2019	62	29.7
Do you experience side effects?
Yes	87	41.6
No	122	58.4
Types of side effects
Nausea	25	28.7
Fatigue	23	26.4
Arthralgia	20	23.0
Weight gain	9	10.3
Sleep disorder	7	8.0
Hot flash	3	3.4
Types of payment
Free of charge	112	53.6
Out-off-pocket money	66	31.6
Medical insurance	31	14.8
Follow-up status
1 year	110	52.6
2 years	38	18.2
3 years	20	9.6
4 years	24	11.5
5 years	17	8.1

Table 5 Health-care System-Related Factors of Women with Breast Cancer Attending Oncology Center at TASH, Addis Ababa, Ethiopia, 2019 (N=209)

Variable	Frequency (N)	Percentage (%)
Availability of adjuvant hormonal therapy
Yes	73	34.9
No	136	65.1
Did you get thorough therapeutic communication from HCP?
Not at all	31	14.8
Somewhat	69	33.0
Very well	109	52.2
Travel time to hospital
<3 h	31	14.8
3–6 h	76	36.4
≥7 h	102	48.8

Figure 2 AHT adherence among women with breast cancer attending oncology center at TASH, Addis Ababa, Ethiopia, 2019 (N=209).

Table 6 Bivariate and Multivariate Analysis of Factors Associated with Adherence to AHT Among Women with Breast Cancer Attending Oncology Center at TASH, Addis Ababa, Ethiopia, 2019

Characteristics	Outcomes		COR (95%CI)	AOR (95%CI)	P-value
	Adherent N (%)	Nonadherent N (%)
Residence
Rural	64 (73)	24 (27)	0.473 (0.379–0.590)	0.859 (0.320–2.305)	0.763
Urban	98 (81)	23 (19)	1	1	1
Educational status
High school and above	87 (84)	16 (16)	0.184 (0.108–0.313)	0.575 (0.180–1.840)	0.351
Primary education	38 (72)	15 (28)	0.395 (0.217–0.718)	0.691 (0.228–2.091)	0.513
Unable to read and write	37 (70)	16 (30)	1	1	1
Getting social support
Yes	46 (67%	23 (33)	0.500 (0.303–0.825)	3.959 (1.57–9.98)	0.004*
No	116 (83)	24 (17)	1	1	1
Family history
Yes	16 (84)	3 (16)	0.534 (0.452–0.632)	1.399 (0.262–7.481)	0.695
No	146(77)	44 (23)	1	1	1
Types of breast cancer
Lobular	17 (77)	5 (23)	0.340 (0.253–0.457)	0.499 (0.115–2.166)	0.353
Ductal	145 (78)	42 (22)	1	1	1
Stage of breast cancer
Early stage	47 (81)	11 (19)	0.234 (0.121–0.451)	1.289 (0.461–3.601)	0.628
Advanced stage	115 (76)	36 (24)	1	1	1
Types of adjuvant hormonal therapy
Anastrozole	81 (89)	10 (11)	0.123 (0.064–0.238)	0.139 (0.040–0.485)	0.002*
Tamoxifen	81 (69)	37 (31)	1	1	1
Time of initiation
2015	26 (72)	10 (28)	0.216 (0.112–0.414)	0.877 (0.281–2.739)	0.822
2016	20 (83)	4 (17)	0.318 (0.174–0.581)	0.399 (0.052–3.029)	0.374
2017	21 (72)	8 (28)	0.381 (0.169–0.860)	0.125 (0.006–2.494)	0.174
2018	44 (76)	14 (24)	0.200 (0.068–0.585)	0.206 (0.015–2.838)	0.238
2019	51 (82)	11 (18)	1	1	1
Experiencing side effects
Yes	57 (66)	30 (34)	0.162 (0.097–0.270)	0.210 (0.085–0.517)	0.001*
No	105 (86)	17 (14)	1	1	1
Types of payment
Free of charge	89 (79)	23 (21)	0.258 (0.163–0.409)	2.044 (0.494–8.453)	0.324
Out-of-pocket-money	47 (71)	19 (29)	0.404 (0.237–0.689)	1.517 (0.356–6.462)	0.573
Medical insurance	26 (84)	5 (16)	1	1	1
Getting a thorough therapeutic communication
Very well	83 (76)	26 (24)	0.313 (0.202–0.487)	4.590 (1.061–19.863)	0.041*
Some what	54 (78)	15 (22)	0.278 (0.157–0.492)	2.945 (0.676–12.841)	0.150
Not at all	25 (81)	6 (19)	1	1	1
Types of surgery
Mastectomy	150 (79)	39 (21)	0.260 (0.183–0.370)	0.215 (0.059–0.788)	0.045*
Lumpectomy	12 (60)	8 (40)	1	1	1

Note: *Indicates significantly associated.