Education & Support Patient Adherence

Treatment adherence—a matter for discussion

Adherence is a challenge in adjuvant treatment. Studies show that patients undergoing adjuvant hormonal treatment for breast cancer are generally adherent for the first year.12 Up to 50% of all breast cancer patients are nonadherent by year 3.18 So many are not receiving the full potential benefit of treatment.

Discuss adherence at every visit

Open, direct discussion with your patient about the specific risks of not adhering to treatment may help increase adherence and best outcomes. A recent study of oncologist-patient discussions recommends that physicians address the issue of adherence and persistence to treatment at every office visit.12

During the discussion, it is important to12

  • Ask open-ended questions to address both the emotional as well as the technical aspects of adhering to treatment
  • Reinforce that there are data to show that patients are increasing their chances of staying cancer free by taking hormonal treatment

Below are some suggested open-ended questions that may lead to meaningful dialogue about adherence and persistence with your patients.

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Questions to encourage patient adherence

To encourage a dialogue about adherence and persistence, you may want to ask the following.12

  • Tell me how you take the medication.
  • How do you feel about taking your medication these days?
  • We're talking about taking medication for (indicate how long the patient will be on treatment) years. What do you think about that?
  • Are there any reasons you are considering stopping taking your medication? Let's talk about them for a minute.

To encourage conversation about study results that support the value of adherence, you may want to ask the following.12

  • What have you been reading about treatment of breast cancer these days? Any questions about what you've seen?
  • Tell me if you have any opinions or questions about the new data on hormonal breast cancer therapies. That's why I'm here.

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"Survivorship in Early Breast Cancer" InfoSite

Survivorship care is increasingly recognized as a distinct phase of cancer care, and there has been a dramatic acceleration of research in the area in the past few years. With over 2.4 million breast cancer survivors in the US, there is tremendous interest and need for information about survivorship issues in breast cancer.19,20

The "Survivorship in Early Breast Cancer" InfoSite is an online resource from AstraZeneca developed in partnership with Medscape and under the guidance of a distinguished faculty.

This site includes

  • Up-to-date information about supporting survivorship
  • Videos with commentary from experts
  • A portal to patient resources

Long-term outcomes in early breast cancer are discussed, including data from the ATAC study with Arimidex. The importance of adherence to adjuvant hormonal treatment is discussed in the broader context of supporting survivorship.

Go to the "Survivorship in Early Breast Cancer" InfoSite

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Important Information About Arimidex® (anastrozole) Tablets

Arimidex is indicated for adjuvant treatment of postmenopausal women with hormone receptor-positive early breast cancer.

Arimidex is indicated for first-line treatment of postmenopausal women with hormone receptor-positive or hormone receptor-unknown locally advanced or metastatic breast cancer and for the treatment of advanced breast cancer in postmenopausal women with disease progression following tamoxifen therapy. Patients with estrogen receptor-negative disease and patients who did not respond to previous tamoxifen therapy rarely responded to Arimidex.

Important Safety Information About Arimidex

  • Arimidex is only for postmenopausal women. Arimidex can cause fetal harm when administered to a pregnant woman. Before starting treatment with Arimidex, pregnancy must be excluded (see WARNINGS section of full Prescribing Information)
  • In women with preexisting ischemic heart disease 465/6186 (7.5%), an increased incidence of ischemic cardiovascular events occurred with Arimidex (17%) vs tamoxifen (10%). In this patient population, angina pectoris was reported in 25/216 (11.6%) vs 13/249 (5.2%) and myocardial infarction was reported in 2/216 (0.9%) vs 8/249 (3.2%) patients receiving Arimidex and tamoxifen, respectively
  • Compared to baseline, Arimidex showed a mean decrease in both lumbar spine and total hip bone mineral density. Tamoxifen showed a mean increase in these measurements. Nine percent of patients receiving Arimidex had an elevated serum cholesterol vs 3.5% of patients receiving tamoxifen
  • Common side effects seen with Arimidex vs tamoxifen in the early breast cancer trial after 5 years of treatment include hot flashes (36% vs 41%), joint disorders (including arthritis, arthrosis, arthralgia) (36% vs 29%), asthenia (19% vs 18%), mood disturbances (19% vs 18%), pain (17% vs 16%), pharyngitis (14% vs 14%), nausea and vomiting (13% vs 12%), rash (11% vs 13%), depression (13% vs 12%), hypertension (13% vs 11%), osteoporosis (11% vs 7%), peripheral edema (10% vs 11%), lymphedema (10% vs 11%), back pain (10% vs 10%), insomnia (10% vs 9%), and headache (10% vs 8%). Fractures, including fractures of the spine, hip, and wrist, occurred more often with Arimidex vs tamoxifen (10% vs 7%)
  • In the advanced breast cancer studies, the most common (occurring with an incidence of >10%) side effects occurring in women taking Arimidex included hot flashes, nausea, asthenia, pain, headache, back pain, bone pain, increased cough, dyspnea, pharyngitis, and peripheral edema. Joint pain/stiffness has been reported in association with the use of Arimidex
  • Clinical and pharmacokinetic results suggest that tamoxifen should not be administered with Arimidex. Estrogen-containing therapies should not be used with Arimidex as they may diminish its pharmacologic action

Please click here for full Prescribing Information.