Adherence to Adjuvant Tamoxifen in Mexican Young Women with Breast Cancer

Figures & data

Table 1 Sociodemographic Characteristics

	n = 141 (100%)
Mean age at diagnosis (SD)	35.7 (±4.4)
Stage at diagnosis
Early stage (0, I, II)	92 (65.2)
Advanced stage (III and IV)	45 (31.9)
Unknown	4 (2.9)
Mean time on tamoxifen treatment (SD)	26.7 months (± 17.2)
Education
Elementary school	13 (9.2)
Middle school	45 (31.9)
High school	37 (26.2)
University	46 (32.6)
Marital status
Unpartnered (single/divorcee/widow)	70 (49.6)
Partnered (married/in a domestic partnership)	71 (50.4)
Stable job at time of survey (yes)	35 (24.8)
Number of children at diagnosis
0	48 (34)
1	25 (17.7)
2	43 (30.5)
3	21 (14.9)
≥ 4	4 (2.8)
Number of children at time of survey
0	47 (33.3)
1	24 (17)
2	44 (31.2)
3	21 (14.9)
≥ 4	5 (3.5)
Perceived financial problems
Yes	99 (70.2)
No	42 (29.8)
Perceived financial status
Money for extras	4 (2.8)
Little money for extras	19 (13.5)
Pay bills through cutting back	63 (44.7)
Difficulty paying bills	55 (39)
Number of people that contribute economically in the household
0	10 (7.1)
1–2	119 (84.4)
3–4	10 (7.1)
5–6	2 (1.4)
Psychological support since diagnosis
Yes	62 (44)
No	79 (56)
Number of people in social support network
0	5 (3.5)
1–2	32 (22.7)
3–4	23 (26.3)
5–6	12 (8.5)
≥ 6	69 (48.9)

Table 2 Self-Reported Survey

	n = 141 (100%)
Do you take tamoxifen regularly?
Yes	134 (95)
No	7 (5)
How many doses of tamoxifen have you missed in the last month (30 days)?
0 (100% adherent)	98 (69.5)
1–6 (80–99% adherent)	35 (24.8)
7–30 (<80% adherent)	7 (5)
Do you ever forget to take tamoxifen?
Never	86 (61)
Rarely	45 (31.9)
Sometimes	8 (5.7)
Often	2 (1.4)
Always	0 (0)
Sometimes if you feel worse when you take tamoxifen, do you stop taking it?
Never	128 (90.8)
Rarely	6 (4.3)
Sometimes	6 (4.3)
Often	1 (0.6)
Always	0 (0)
Do you alter the dose of tamoxifen from what has been prescribed by your physician?
Never	138 (97.9)
Rarely	2 (1.4)
Sometimes	1 (0.7)
Often	0 (0)
Always	0 (0)
Do you take other medications in addition to tamoxifen?
Yes	47 (33.3)
No	94 (66.7)
If yes, how many medications do you take in addition to tamoxifen?
1	17 (36.2)
2	15 (31.9)
3	9 (19.1)
4	3 (6.4)
≥ 5	1 (2.1)
Did you have the opportunity to ask your physician questions about tamoxifen before treatment initiation?
Yes	92 (65.2)
No	49 (34.8)
Do you consider that the information provided by your physician regarding tamoxifen was sufficient?
Yes	62 (44)
No	79 (56)
Do you consider that the information provided by your physician regarding tamoxifen was understandable?
Yes	89 (63.1)
No	52 (36.9)
Have you experienced side effects from tamoxifen?
Yes	101 (71.6)
No	40 (28.4)
If so, which are the most important side effects that you have experienced from tamoxifen?
Menopause-related symptoms	65 (64.4)
General symptoms	50 (49.5)
Articular symptoms	24 (23.8)
Other symptoms	25 (24.8)

Figure 1 Graded perceptions towards tamoxifen.

Table 3 Association Between Subjective an Objective Adherence

	MPR <80% n = 27	MPR ≥80% n = 80	p
Self-reported adherence	23 (22.5%)	79 (77.5%)	0.004
Self-reported non-adherence	4 (80%)	1 (20%)

Table 4 Associations Between Adherence and Patients’ Characteristics

	Subjective Adherence		Objective Adherence
	Does Not Take Tamoxifen Regularly n = 7 (100%)	Takes Tamoxifen Regularly n = 134 (100%)	MPR <80 n = 27 (100%)	MPR ≥80 n = 80 (100%)
Mean age at diagnosis	35.71	35.7	35.89	35.96
Stage at diagnosis
Stage (0, I, II)	4 (57.1)	88 (67.7)	18 (66.7)	52 (66.7)
Stage (III, IV)	3 (42.9)	42 (32.3)	9 (33.3)	26 (33.3)
Time on tamoxifen treatment (months)	28.5	25.5	37.9	21.3
Education level
Elementary school	1 (14.3)	12 (9)	2 (7.4)	8 (10)
Middle school	3 (42.9)	42 (31.3)	9 (33.3)	25 (31.3)
High school	2 (28.6)	35 (26.1)	6 (22.2)	26 (32.5)
University	1 (14.3)	45 (33.6)	10 (37)	21 (26.3)
Marital status
Unpartnered (single/divorcee/widow)	2 (28.6)	68 (50.7)	11 (40.7)	42 (52.5)
Partnered (married/domestic partnership)	5 (71.4)	66 (49.3)	16 (59.3)	38 (47.5)
Stable job at time of survey (yes)	2 (28.6)	33 (24.6)	11 (40.7)	17 (21.3)
Number of children at diagnosis
0	1 (14.3)	47 (35.1)	8 (29.6)	26 (32.5)
≥1	6 (85.7)	87 (64.9)	19 (70.4)	54 (67.5)
Number of children at time of survey
0	1 (14.3)	46 (34.3)	8 (29.6)	26 (32.5)
≥1	6 (85.7)	88 (65.7)	19 (70.4)	54 (67.5)
Perceived financial problems (yes)	5 (83.3)	94 (70.1)	19 (70.4)	58 (72.5)
Perceived financial status
Money for extras	0	4 (3)	1 (3.7)	3 (3.8)
Little money for extras	1 (14.3)	18 (13.4)	6 (22.2)	6 (7.5)
Pay bills through cutting back	4 (57.1)	59 (44)	10 (37)	40 (50)
Difficulty paying bills	2 (28.6)	53 (39.6)	10 (37)	31 (38.8)
Number of people that contribute economically in the household
0–2	7 (100)	122 (91)	24 (88.9)	74 (92.5)
3–6	0	12 (9)	3 (11.1)	6 (7.5)
Psychological support since diagnosis	5 (71.4)	57 (42.5)	10 (37)	37 (46.3)
Number of people in social support network
0–6	4 (57.1)	68 (50.7)	15 (55.6)	43 (53.8)
≥6	3 (42.9)	66 (49.3)	12 (44.4)	37 (46.3)
Sometimes if you feel worse when you take tamoxifen, do you stop taking it?
Never	3 (42.9)	125 (93.3)	20 (74.1)	76 (95)
Rarely/Sometimes/Often/Always	4 (57.1)	9 (6.7)	7 (25.9)	4 (5)
Do you take other medications in addition to tamoxifen? (yes)	1 (14.3)	46 (34.3)	4 (14.8)	33 (41.3)
Did you have the opportunity to ask your physician questions about tamoxifen before treatment initiation? (yes)	4 (57.1)	88 (65.7)	18 (66.7)	55 (68.8)
Do you consider that the information provided by your physician regarding tamoxifen was sufficient? (yes)	2 (28.6)	60 (44.8)	15 (55.6)	39 (48.8)
Do you consider that the information provided by your physician regarding tamoxifen was understandable? (yes)	2 (28.6)	87 (64.9)	19 (70.4)	54 (67.5)
Have you experienced side effects from tamoxifen? (yes)	6 (85.7)	95 (70.9)	19 (70.4)	57 (71.3)