| Objective: Review of the literature suggests that there is a gap in understanding the psychosocial factors affecting adherence to Aromatase Inhibitors (AI). The aim of this study is to identify and assess the factors affecting adherence to Aromatase Inhibitor Theory in breast cancer patients using the Protection Motivation.;Methods: Cross-sectional retrospective study. 288 patients, taking aromatase inhibitors as adjuvant therapy, were identified using a cancer registry managed by a University-based medical center. A survey instrument measuring patient's medication taking behavior was developed using the Protection Motivation Theory, which was mailed to the patients. The Morisky Scale was used to measure adherence to Aromatase Inhibitor, on a scale of 0-8. ANOVA, Pearson's correlation and Multiple Regression were used to analyze the data using SPSS with significance being measured at the 0.05 alpha level.;Results: 145 responses were received bringing the response rate to a 54.10%. Out of the 145 patients, 6 who had discontinued Aromatase Inhibitor therapy on doctors' orders were removed from the final analysis. The patients scored a mean of 6.84 (+0.66) and a median of 7.75 on the Morisky Scale. Using the mean as a cutoff, 38% of the patients were non-adherent to their medications including 6 who had discontinued therapy for reasons other than doctors' orders. The level of protection motivation showed a significant positive correlation with the adherence scale (r=0.310). Multiple regression revealed that Coping Appraisal was a better predictor of adherence (β=0.437), while Threat Appraisal did not show a significant correlation. Pearson's Correlation revealed that Self Efficacy (r=0.485) and Response Efficacy (r=0.206) showed a positive correlation with adherence while Response Cost (r=-0.235) showed a negative correlation. A second multiple regression showed that Self Efficacy was the only significant predictor of adherence (β = 0.429). Other factors attributing to lower adherence were younger and older age, not being married, insurance status (private insurance and Medicare), lower income and presence of more than 3 comorbid conditions.;Conclusion: The results of the study indicate that Protection motivation theory was somewhat useful to explain adherence to Aromatase Inhibitor in breast cancer patients. |
