Effects of Pre-existing Mental Health Disorders on Endocrine Therapy Adherence in Patients with Breast Cancer
Author(s)
Aubree Seibert-Jeffrey, BA, BS1, Grishma KC, BS2, Chenghui Li, PhD2;
1UAMS, Student, Little Rock, AR, USA, 2University of Arkansas for Medical Sciences, Little Rock, AR, USA
1UAMS, Student, Little Rock, AR, USA, 2University of Arkansas for Medical Sciences, Little Rock, AR, USA
OBJECTIVES: When using adjuvant endocrine therapy (ET) to treat breast cancer, adherence is highly important. While mental health is a concern for adherence in many conditions, preexisting mental health conditions are of particular interest in these medications targeting hormone receptors. This study analyzed the effect of having pre-existing mental health conditions on ET adherence
METHODS: Women newly diagnosed with early stage (0-3) hormone receptor positive breast cancer who initiated ET therapy within one year of diagnosis were identified from the Arkansas Cancer Registry linked with the All-Payer Claims Database. Adherence during the first year of ET use was assessed using proportion of days covered (PDC). Pre-existing mental health conditions were defined using diagnosis codes in the six months before ET initiation. Logistic models were used to determine the association between high adherence (>80% PDC) and pre-existing mental health conditions, adjusting for sociodemographic and clinical characteristics.
RESULTS: 3,850 breast cancer patients were included in the study, of which 15.69% had prior mental health conditions. 72.1% of patients without and 69% of patients with prior mental health conditions had high adherence. The two groups differed in age, marital status, insurance type, Charlson comorbidity index and year of ET initiation. Both unadjusted (OR=0.86, 95% CI: 0.72-1.04) and adjusted (OR=0.93, 95% CI: 0.76-1.14) logistic regressions showed a non-significant decrease in odds of high adherence among patients with pre-existing mental health conditions compared to patients without.
CONCLUSIONS: Pre-existing mental health conditions were not significantly associated with ET adherence during the first year of ET use.
METHODS: Women newly diagnosed with early stage (0-3) hormone receptor positive breast cancer who initiated ET therapy within one year of diagnosis were identified from the Arkansas Cancer Registry linked with the All-Payer Claims Database. Adherence during the first year of ET use was assessed using proportion of days covered (PDC). Pre-existing mental health conditions were defined using diagnosis codes in the six months before ET initiation. Logistic models were used to determine the association between high adherence (>80% PDC) and pre-existing mental health conditions, adjusting for sociodemographic and clinical characteristics.
RESULTS: 3,850 breast cancer patients were included in the study, of which 15.69% had prior mental health conditions. 72.1% of patients without and 69% of patients with prior mental health conditions had high adherence. The two groups differed in age, marital status, insurance type, Charlson comorbidity index and year of ET initiation. Both unadjusted (OR=0.86, 95% CI: 0.72-1.04) and adjusted (OR=0.93, 95% CI: 0.76-1.14) logistic regressions showed a non-significant decrease in odds of high adherence among patients with pre-existing mental health conditions compared to patients without.
CONCLUSIONS: Pre-existing mental health conditions were not significantly associated with ET adherence during the first year of ET use.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
CO165
Topic
Clinical Outcomes
Topic Subcategory
Performance-based Outcomes
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, SDC: Oncology