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Geographic Variations and the Associated Factors in Adherence to and Persistence with Adjuvant Hormonal Therapy for the Privately Insured women Aged 18–64 with Breast Cancer in Texas

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Názov: Geographic Variations and the Associated Factors in Adherence to and Persistence with Adjuvant Hormonal Therapy for the Privately Insured women Aged 18–64 with Breast Cancer in Texas
Autori: Junghyun Kim, Man S. Kim, Suja S. Rajan, Xianglin L. Du, Luisa Franzini, Tae Gi Kim, Sharon H. Giordano, Robert O. Morgan
Prispievatelia: Junghyun Kim, Man S Kim, Suja S Rajan, Xianglin L Du, Luisa Franzini, Tae Gi Kim, Sharon H Giordano, Robert O Morgan, Kim, Jung Hyun
Zdroj: Curr Oncol
Current Oncology, Vol 30, Iss 4, Pp 3800-3816 (2023)
Current Oncology; Volume 30; Issue 4; Pages: 3800-3816
Informácie o vydavateľovi: MDPI AG, 2023.
Rok vydania: 2023
Predmety: Antineoplastic Agents, Hormonal, Antineoplastic Agents, Breast Neoplasms* / epidemiology, Breast Neoplasms, geographic variation, Article, Medication Adherence, Insurance, adjuvant hormonal therapy, breast cancer, adherence, persistence, Medical Specialties, Medicine and Health Sciences, Chemotherapy, Humans, Adjuvant, RC254-282, Retrospective Studies, Insurance, Health, Hormonal, Hormonal / therapeutic use, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, Texas, 3. Good health, Oncology, Health, Chemotherapy, Adjuvant, Female, Public Health, Breast Neoplasms* / drug therapy
Popis: The purpose of this study is to examine the geographical patterns of adjuvant hormonal therapy adherence and persistence and the associated factors in insured Texan women aged 18–64 with early breast cancer. A retrospective cohort study was conducted using 5-year claims data for the population insured by the Blue Cross Blue Shield of Texas (BCBSTX). Women diagnosed with early breast cancer who were taking tamoxifen or aromatase inhibitors (AIs) for adjuvant hormonal therapy with at least one prescription claim were identified. Adherence to adjuvant hormonal therapy and persistence with adjuvant hormonal therapy were calculated as outcome measures. Women without a gap between two consecutively dispensed prescriptions of at least 90 days were considered to be persistently taking the medications. Patient-level multivariate logistic regression models with repeated regional-level adjustments and a Cox proportional hazards model with mixed effects were used to determine the geographical variations and patient-, provider-, and area-level factors that were associated with adjuvant hormonal therapy adherence and persistence. Of the 938 women in the cohort, 627 (66.8%) initiated adjuvant hormonal therapy. Most of the smaller HRRs have significantly higher or lower rates of treatment adherence and persistence rates relative to the median regions. The use of AHT varies substantially from one geographical area to another, especially for adherence, with an approximately two-fold difference between the lowest and highest areas, and area-level factors were found to be significantly associated with the compliance of AHT. There are geographical variations in AHT adherence and persistence in Texas. Patient-level and area-level factors have significant associations explaining these patterns.
Druh dokumentu: Article
Other literature type
Popis súboru: application/pdf
Jazyk: English
ISSN: 1718-7729
DOI: 10.3390/curroncol30040288
Prístupová URL adresa: https://pubmed.ncbi.nlm.nih.gov/37185401
https://doaj.org/article/73022fb7981d4d3dbb8fc6963d386ff9
Rights: CC BY
CC BY NC ND
Prístupové číslo: edsair.doi.dedup.....9b31cb7627c948e8082b374a5e8d8aa5
Databáza: OpenAIRE
Popis
Abstrakt:The purpose of this study is to examine the geographical patterns of adjuvant hormonal therapy adherence and persistence and the associated factors in insured Texan women aged 18–64 with early breast cancer. A retrospective cohort study was conducted using 5-year claims data for the population insured by the Blue Cross Blue Shield of Texas (BCBSTX). Women diagnosed with early breast cancer who were taking tamoxifen or aromatase inhibitors (AIs) for adjuvant hormonal therapy with at least one prescription claim were identified. Adherence to adjuvant hormonal therapy and persistence with adjuvant hormonal therapy were calculated as outcome measures. Women without a gap between two consecutively dispensed prescriptions of at least 90 days were considered to be persistently taking the medications. Patient-level multivariate logistic regression models with repeated regional-level adjustments and a Cox proportional hazards model with mixed effects were used to determine the geographical variations and patient-, provider-, and area-level factors that were associated with adjuvant hormonal therapy adherence and persistence. Of the 938 women in the cohort, 627 (66.8%) initiated adjuvant hormonal therapy. Most of the smaller HRRs have significantly higher or lower rates of treatment adherence and persistence rates relative to the median regions. The use of AHT varies substantially from one geographical area to another, especially for adherence, with an approximately two-fold difference between the lowest and highest areas, and area-level factors were found to be significantly associated with the compliance of AHT. There are geographical variations in AHT adherence and persistence in Texas. Patient-level and area-level factors have significant associations explaining these patterns.
ISSN:17187729
DOI:10.3390/curroncol30040288