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The relationship between medication adherence and illness perception in breast cancer patients with adjuvant endocrine therapy: beliefs about medicines as mediators

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Abstract

Purpose

To describe medication adherence, to analyze the relationships among medication adherence, illness perception, and beliefs about medicines, and to determine the mediating effects of beliefs about medicines on the relationship in breast cancer patients with adjuvant endocrine therapy (AET) in China.

Methods

A cross-sectional study was conducted on 202 breast cancer patients with AET from September 2017 to February 2019 in China. The Medication Adherence Report Scale (MARS-5), the Chinese version of the revised illness perception questionnaire for Breast Cancer (CIPQ-R-BC) and the Beliefs about Medicines Questionnaire (BMQ) were used.

Results

The mean MARS-5 score of our participants was 23.72 (SD = 1.62), and 175 (86.6%) patients were adherent to medications. Moreover, medication adherence was negatively correlated with identity, environmental or immune factors, emotional representations, BMQ-specific concerns, BMQ-general overuse, and BMQ-general harm, as well as being positively correlated with coherence and the total BMQ scores. Furthermore, beliefs in the overuse about medicines functioned as mediators for the influencing effects of coherence and emotional representations on medication adherence.

Conclusion

Illness perception not only directly affected medication adherence, but also indirectly affected medication adherence through the beliefs about medicines. Necessary interventions that target beliefs in the overuse about medicines in breast cancer patients with AET with low levels of coherence or high levels of emotional representations could be provided to improve the level of their medication adherence.

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Acknowledgements

The authors would like to thank the medical staff and all the participants.

Funding

This research was supported by the National Natural Science Foundation of China (Grant Number. 71974217).

Author information

Author notes

  1. Meng Zhao and Jing Zhao contributed equally to this work.

Authors and Affiliations

  1. School of Nursing, Sun Yat-Sen University, Guangzhou, Guangdong Province, China

    Meng Zhao, Jing Chen, Mingfang Li, Xia Luo, Yue Zhang, Chenxia Xiong, Zijun Guo & Jun Yan

  2. Tian Shui Health Commission, Tianshui, Gansu Province, China

    Jing Zhao

  3. Department of Breast Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong Province, China

    Lijuan Zhang

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  1. Meng Zhao
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Contributions

Conceptualization: Jun Yan.

Acquisition of data: Meng Zhao and Jing Zhao.

Analysis and/or interpretation of data: Meng Zhao and Jing Chen.

Drafting the manuscript: Meng Zhao and Jing Zhao.

Revising the manuscript critically for important intellectual content: Jun Yan, Jing Chen, Mingfang Li, Lijuan Zhang, Xia Luo, and Yue Zhang.

Data validation: Jun Yan, Yue Zhang, Chenxia Xiong, and Zijun Guo.

Supervision: Jun Yan.

All authors have read and approved the manuscript.

Corresponding author

Correspondence to Jun Yan.

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Ethics approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Research Ethical Committee of the Sixth Affiliated Hospital of Sun Yat-Sen University (L2019ZSLYEC-001).

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All participants included in the study provided written informed consent.

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Zhao, M., Zhao, J., Chen, J. et al. The relationship between medication adherence and illness perception in breast cancer patients with adjuvant endocrine therapy: beliefs about medicines as mediators. Support Care Cancer 30, 10009–10017 (2022). https://doi.org/10.1007/s00520-022-07411-w

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