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. 2015 Jul;105(Suppl 3):e4–e15. doi: 10.2105/AJPH.2014.302490

TABLE 4—

Correlates of Endocrine Therapy Initiation, Persistence, and Adherence Among Minority and Low-Income Populations and Subpopulations in Included Studies

Correlate Initiation Adherence Persistence
Age
 Older Positive,60,82 NS87,80 Negative,19 NS60 Negative,80 NS81
 Younger Negative19
Married Positive,82 negative60 Negative,60 NS22 Negative,60 NS81
Education NS81
Financial adequacy NS81
Blind or disabled NS87
Comorbidity Negative,82 NS60,85,87 Positive,19 NS60 Positive60,81
High hierarchical condition category (insurance risk) Positive,22 NS22
Preexisting depression NS85
History of estrogen replacement therapy NS19
No. of prescription medications Positive60 NS60 Positive,89 NS60
Hormone receptor positive status Positive60 NS60 NS60
Stage Negative,85 NS80,87 NS,22 positive22 NS80,81
 Grade 2 (vs 1) Positive80,82 NS80
 Grade 3 (vs 1) NS80,82 NS80
Well differentiated (vs poorly) Positive85
Moderately differentiated (vs poorly) Positive85
Unknown differentiation (vs poorly) NS85
Lobular (vs ductal) Positive82
Other nonlobular histology (vs ductal) Negative82
Regional (direct extension or lymph node) vs local Positive60,82 NS60 Positive60
Regional (direct extension and lymph node) vs local NS82
Mastectomy (vs BCS and/or no surgery) Positive,82 NS60,87 Negative,19 NS22,60 NS60,81
BCS no radiation (vs BCS with radiation) Negative85
Mastectomy, no radiation (vs mastectomy with radiation) NS85
Adjuvant chemotherapy Negative,60,85 NS82,87 NS19,60 NS60,81
Radiation Positive,60 NS87 NS19,60 NS60,81
Perceived importance of ET Positive78
Value provider’s opinion Positive78
Concern about side effects NS78
Worry about recurrence Positive80 NS80
Perceived efficacy in patient-provider interactions Positive81
ET side effects Negative81
Out-of-pocket costs Negative22
No insurance Negative81
Insurance plan type (public employee versus other) NS85 NS19,22
Age at Part D enrollment NS22
Breast Cancer Cervical Cancer Control Program (vs Medicaid only) Positive87
Oncology visit within year Positive19
Primary oncology provider: medical oncology (vs surgeon) Positive80 NS80
Patient-centered care Positive81
Discussion about ET NS81
Received enough information about ET Positive80
Use of other prescriptions (nonbaseline) NS19
No. of outpatient visits NS19
Nursing home use NS19
Days of acute hospitalization in prior y NS19
Urban NS60,87 NS22,60 NS60
Small hospital (vs large) Positive60 NS60 NS60
Zip code income ($30 000–$40 000 vs < $30 000) Positive,22 NS22
% county poverty
 Lowest quartile vs high mid NS85
 Lowest quartile vs highest NS85
 Lowest quartile vs low mid Negative85
No. hospitals with oncology services in county
 Lowest quartile vs high mid NS85
 Lowest quartile vs highest NS85
 Lowest quartile vs low mid Negative85
Calendar year Positive,82 negative,87 NS85 Negative,22 NS19,22

Note. BCS = Breast-conserving surgery; ET = endocrine therapy; negative = negative association with outcome (P ≤ .05); NS = nonsignificant association with outcome (P > .05); positive = positive association with outcome (P ≤ .05). Studies that looked at adjuvant breast cancer treatment broadly are not included. For studies that looked at racial/ethnic and socioeconomic subpopulations, only multivariable regression results for racial/ethnic minorities or low-income populations are included in this table.