Use of Adjuvant Endocrine Therapy Among Post-Menopausal Breast Cancer Patients in Malaysia

Athirah Saiful Bahri, Tuan Mazlelaa Tuan Mahmood, Siti Azdiah Abdul-Aziz, Mohd Makmor-Bakry, Noraida Mohamed Shah Centre of Quality Management of Medicines, Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Kuala Lumpur, MalaysiaCorrespondence: Noraida Mohamed ShahCentre of Quality Management of Medicines, Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, 50300, MalaysiaTel +60 3 9289 8038Email noraida_mshah@ukm.edu.myContext: Globally, breast cancer is the most common cancer affecting women, and adjuvant endocrine therapy (AET) is part of its treatment modality, which improves patients’ outcome. However, there are concerns on side effects related to its use, which may affect treatment adherence.Purpose: This study was conducted to explore attitude and practice on using AET among breast cancer patients in Malaysia.Patients and Methods: Postmenopausal breast cancer patients on at least 3 months of AET attending the outpatient oncology clinic at a tertiary care hospital were interviewed. Patients underwent in-depth interviews exploring their attitude and practices while on AET using a semi-structured interview guide. The interviews were transcribed verbatim and analyzed using thematic analysis.Results: There were four main themes for attitude toward the use of AET: 1) benefits of using AET, 2) concerns on taking AET, 3) beliefs on alternative treatment, and 4) beliefs toward the doctor. For practice, six themes were obtained: 1) correct use of AET, 2) appointment adherence, 3) information-seeking behavior, 4) counseling services obtained, 5) experienced side effects of AET, and 6) usage of complementary and alternative medicines.Conclusion: Several themes concerning attitude and practice of breast cancer patients receiving AET were identified, which may be addressed during treatment consultations in clinical practice.Keywords: adjuvant endocrine therapy, breast cancer, interview, attitude, practice