The resilient study: A retrospective, descriptive correlational investigation of rate and correlates of oral endocrine therapy adherence in older women with breast cancer
Sunny Yoo Ruggeri, PhD
- Sigma Affiliation
- Lambda Phi
Visits vs Downloads
Visitors - World Map
Top Visiting Countries
Top Visiting Cities
Visits (last 6 months)
Downloads (last 6 months)
Popular Works for Ruggeri, Sunny Yoo by View
Popular Works for Ruggeri, Sunny Yoo by Download
Breast cancer is the most prevalent and costly cancer among females. About 80% of breast cancer patients take oral endocrine therapy (OET), such as anastrozole, letrozole, tamoxifen, and exmestane. These medications increase survival, improve quality-of-life and decrease healthcare costs, yet many patients do not take it properly. The purpose of this study is to identify rates of and multi-level determinants influencing OET non-adherence (NA) among older women with breast cancer enrolled in Medicare Part-D. It is important to consider older women with breast cancer; the medium breast cancer patient age was 62 and more than 20% of newly diagnosed patients were older than 70 in 2021.
Most existing research on OET-NA has been conducted on small samples at single sites and has focused predominantly on patient issues rather than exploring multi-level determinants. Despite their unique needs due to aging effects, there are no specific guidelines or known OET-NA determinants for older women with breast cancer. To resolve this, I utilized a large data set with theoretical frameworks (World Health Organization’s five-dimensional-model of factors and Bronfenbrenner’s ecological system theory) to understand multi-level determinants through a secondary data analysis of the Surveillance-Epidemiology-End-Results Medicare database (average age 69). All women in the database with a cancer diagnosis were identified using ICD-9 and ICD-10 codes in Medicare Part-D to identify ten years of OET-NA rates. I then focused on the most recently released data from 2019 to identify up-to-date trends in OET-NA determinants.
Results demonstrated that OET-NA was significantly affected by (a) patient-related factors of ethnicity and psychological issues, (b) socioeconomic-related factors of marital status, and lifestyle, (c) therapy-related factors of switching OET medications and increased number of drug therapy experiences, (d) condition-related factors of cancer stage and comorbidities, and (e) health care team/system-related factors of characteristics of healthcare team and system. The first steps in developing interventions for better nursing practice based on strong theoretical frameworks were determining rates and multi-level determinants of OET-NA on older women. This study can also support the implementation of better nursing policies to improve patient education and OET adherence— ultimately decreasing morbidity and mortality, and increasing quality-of-life.
This dissertation has also been disseminated through the ProQuest Dissertations and Theses database. Dissertation/thesis number: 30635315; ProQuest document ID: 2856708241. The author still retains copyright.
This item has not gone through this repository's peer-review process, but has been accepted by the indicated university or college in partial fulfillment of the requirements for the specified degree.
|Review Type||None: Degree-based Submission|
|Research Approach||Quantitative Research|
Oral Endocrine Therapy;
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.
All permission requests should be directed accordingly and not to the Sigma Repository.
All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Showing items related by title, author, creator and subjects.
Oral medication adherence, attitude, and quality of life in older adults with cancer: The impact of motivational interviewing Tipton, JanelleOral medication adherence in the older adult with cancer, age 65 years and older, is a significant clinical problem. Adherence rates are estimated at only 50%, which can lead to suboptimal treatment efficacy, poor symptom ...
Craft, Melissa A. (2016-03-21)Note the start and end dates for the course. If the links to the CNE collection homepage or course are invalid, the course has ended. The item record and file will remain as a permanent entry in the repository in its ...
Sternas, Kathleen A. (2017-07-13)Breast cancer is a major global public health issue. It is the most common disease in women worldwide and the leading cause of death in females including women in Argentina, Uruguay and Brazil (Brunello et al., 2008; ...
A correlational study on spiritual and religious well-being, social determinants of health, and self-efficacy for appropriate medication use among African American women with hypertension Augusta, Tracie L.Background: African American (AA) women are disproportionately affected by hypertension and are less likely to adhere to their medication regimen when compared to White and Hispanic women. Very little is known about ...
Gonzales, Mildred C.; Shiao, Shyang-Yun Pamela K. (2014-11-17)Session presented on Sunday, July 27, 2014: Purpose: The purpose is to disseminate the current scientific evidence, including meta-analyses and a pilot prospective family-based case-control study on genome health on ...