Table 4.
Results from included studies
| Predictor variables
|
Number of studies finding positive/negative effect
|
|||||
|---|---|---|---|---|---|---|
| Adherence | Persistence | |||||
| Clinical variables | ||||||
| Menopausal status (pre vs post) | No effects: 3 | Positive: 0 | Negative: 0 | No effects: 4 | Positive: 0 | Negative: 135 |
| Laterality | No effects: 1 | Positive: 0 | Negative: 0 | No effects: 2 | Positive: 0 | Negative: 0 |
| Larger tumor size | No effects: 1 | Positive: 137 | Negative: 0 | No effects: 10 | Positive: 0 | Negative: 0 |
| More advanced stage | No effects: 12 | Positive: 136 | Negative: 223,33* | No effects: 12 | Positive: 264,92 | Negative: 224,60 |
| Positive lymph node status | No effects: 3 | Positive: 0 | Negative: 18 | No effects: 8 | Positive: 311*,51*,93* | Negative: 126 |
| Radiotherapy | No effects: 11 | Positive: 133* | Negative: 223,58* | No effects: 10 | Positive: 28,56 | Negative: 124 |
| Chemotherapy | No effects: 9 | Positive: 338,39,58 | Negative: 323,33*,95 | No effects: 13 | Positive: 58,35*,49,64,91 | Negative: 224,26* |
| Surgery (yes/no) | No effects: 3 | Positive: 123 | Negative: 0 | No effects: 2 | Positive: 124 | Negative: 0 |
| Mastectomy (yes/no) | No effects: 0 | Positive: 134 | Negative: 19 | No effects: 0 | Positive: 149 | Negative: 0 |
| BCS (vs mastectomy) | No effects: 10 | Positive: 133 | Negative: 28,39 | No effects: 13 | Positive: 0 | Negative: 28,11 |
| Positive HR status | No effects: 3 | Positive: 0 | Negative: 0 | No effects: 5 | Positive: 311,47,48 | Negative: 0 |
| AIs (vs TAM) | No effects: 5 | Positive: 435,36,38,39 | Negative: 423,58*,67,90 | No effects: 6 | Positive: 249,51 | Negative: 190 |
| Switching between TAM and AIs (vs not switching) | No effects: 0 | Positive: 38,38,39* | Negative: 723,28,33*,34,35 | No effects: 1 | Positive: 28,43 | Negative: 224*,62 |
| Presence of comorbidities | No effects: 9 | Positive: 39,46,69* | Negative: 58,27,30,31,34 | No effects: 13 | Positive: 250,92 | Negative: 77,8,10,11*,30,62,63 |
| Diabetes/osteoporosis | No effects: 0 | Positive: 0 | Negative: 0 | No effects: 0 | Positive: 343–45 | Negative: 0 |
| Health care variables | ||||||
| Mastologist visits | No effects: 0 | Positive: 123 | Negative: 0 | No effects: 0 | Positive: 124 | Negative: 0 |
| Oncologist (vs no oncologist) | No effects: 0 | Positive: 29,23 | Negative: 0 | No effects: 3 | Positive: 224,49* | Negative: 0 |
| Oncologist vs surgeon | No effects: 0 | Positive: 0 | Negative: 0 | No effects: 1 | Positive: 0 | Negative: 0 |
| Nonsurgeon as provider | No effects: 0 | Positive: 136 | Negative: 0 | No effects: 0 | Positive: 0 | Negative: 0 |
| Primary care vs oncologist/gynecologist | No effects: 1 | Positive: 0 | Negative: 132 | No effects: 2 | Positive: 0 | Negative: 532,43–45,53* |
| Oncologist vs gynecologist | No effects: 0 | Positive: 0 | Negative: 0 | No effects: 0 | Positive: 0 | Negative: 160 |
| More prescription medications | No effects: 8 | Positive: 233,36 | Negative: 0 | No effects: 3 | Positive: 57,25,26*,54,55 | Negative: 132 |
| Complementary/alternative medicine use | No effects: 0 | Positive: 0 | Negative: 0 | No effects: 0 | Positive: 0 | Negative: 17 |
| 90 days prescription refill period (vs 30 days) | No effects: 0 | Positive: 18 | Negative: 0 | No effects: 0 | Positive: 18 | Negative: 0 |
| More hospitalizations | No effects: 1 | Positive: 0 | Negative: 323,34,36 | No effects: 1 | Positive: 0 | Negative: 324,56,57 |
| Higher monthly costs | No effects: 2 | Positive: 0 | Negative: 430,32,34,52 | No effects: 3 | Positive: 0 | Negative: 230,32 |
| Demographic variables | ||||||
| Family history | No effects: 2 | Positive: 123* | Negative: 0 | No effects: 2 | Positive: 124 | Negative: 0 |
| Having children | No effects: 3 | Positive: 0 | Negative: 0 | No effects: 4 | Positive: 0 | Negative: 0 |
| Secondary or higher education | No effects: 13 | Positive: 123 | Negative: 0 | No effects: 15 | Positive: 124 | Negative: 0 |
| Younger age (<40/50 years) | No effects: 3 | Positive: 159 | Negative: 99,23,28,31,33*,34,38,39,58 | No effects: 6 | Positive: 0 | Negative: 78,24,43,44,54,60,62 |
| Older age (>65/75 years) | No effects: 5 | Positive: 228,60 | Negative: 69,30–33*,59 | No effects: 7 | Positive: 149* | Negative: 98,11,30,32,48,54,57,62,63 |
| Higher mean age (continuous) | No effects: 9 | Positive: 327*,29,67 | Negative: 169* | No effects: 4 | Positive: 155 | Negative: 236,64 |
| Race (others vs Caucasian) | No effects: 8 | Positive: 0 | Negative: 29,27* | No effects: 7 | Positive: 0 | Negative: 130 |
| Race (black vs Caucasian) | No effects: 3 | Positive: 0 | Negative: 48,31,32,52 | No effects: 5 | Positive: 0 | Negative: 0 |
| Race (Latina vs Caucasian) | No effects: 0 | Positive: 0 | Negative: 0 | No effects: 1 | Positive: 0 | Negative: 0 |
| Race (Hispanic vs Caucasian) | No effects: 5 | Positive: 0 | Negative: 0 | No effects: 4 | Positive: 111* | Negative: 0 |
| Race (Asian vs Caucasian) | No effects: 4 | Positive: 0 | Negative: 0 | No effects: 3 | Positive: 18 | Negative: 0 |
| Race (less-acculturated Latina vs Caucasian) | No effects: 0 | Positive: 0 | Negative: 0 | No effects: 0 | Positive: 150 | Negative: 0 |
| Maori or Pacific vs NZ European | No effects: 0 | Positive: 0 | Negative: 159 | No effects: 0 | Positive: 0 | Negative: 0 |
| With partner/married | No effects: 9 | Positive: 68,23,32,37,52,69* | Negative: 192 | No effects: 7 | Positive: 38,24,64* | Negative: 265*,92 |
| Perceived financial status/problems | No effects: 0 | Positive: 0 | Negative: 135 | No effects: 4 | Positive: 0 | Negative: 0 |
| Lower income/net worth/SES | No effects: 9 | Positive: 0 | Negative: 430,31,68*,69* | No effects: 7 | Positive: 0 | Negative: 131* |
| Smoking | No effects: 0 | Positive: 0 | Negative: 123 | No effects: 1 | Positive: 0 | Negative: 224*,65 |
| Alcohol | No effects: 0 | Positive: 0 | Negative: 123 | No effects: 1 | Positive: 0 | Negative: 124 |
| Higher BMI | No effects: 1 | Positive: 0 | Negative: 0 | No effects: 4 | Positive: 0 | Negative: 0 |
| Psychosocial variables – related to HT treatment and health care professionals | ||||||
| Perceived efficacy of HT | No effects: 1 | Positive: 0 | Negative: 0 | No effects: 0 | Positive: 0 | Negative: 0 |
| HT concern beliefs | No effects: 6 | Positive: 0 | Negative: 227*,67 | No effects: 0 | Positive: 0 | Negative: 0 |
| HT necessity beliefs | No effects: 4 | Positive: 335,66*,67 | Negative: 0 | No effects: 0 | Positive: 0 | Negative: 0 |
| Neutral or negative decisional balance score (beliefs) | No effects: 0 | Positive: 0 | Negative: 0 | No effects: 0 | Positive: 0 | Negative: 225,26 |
| Coping appraisal (beliefs about HT efficacy and self-efficacy over costs) | No effects: 0 | Positive: 169 | Negative: 0 | No effects: 0 | Positive: 0 | Negative: 0 |
| Negative emotions about HT | No effects: 0 | Positive: 0 | Negative: 235,68* | No effects: 0 | Positive: 0 | Negative: 135 |
| Positive emotions about HT | No effects: 1 | Positive: 168* | Negative: 0 | No effects: 0 | Positive: 135 | Negative: 0 |
| Perceived importance of HT | No effects: 0 | Positive: 161 | Negative: 0 | No effects: 0 | Positive: 0 | Negative: 0 |
| Adherence estimator (beliefs about efficacy, value and cost of HT) | No effects: 0 | Positive: 142* | Negative: 0 | No effects: 0 | Positive: 0 | Negative: 0 |
| Symptom attribution | No effects: 1 | Positive: 0 | Negative: 0 | No effects: 0 | Positive: 0 | Negative: 0 |
| Being involved in decision making/discussed HT with doctor | No effects: 0 | Positive: 0 | Positive: 0 | No effects: 2 | Positive: 148 | Negative: 0 |
| Not told about side effects | No effects: 0 | Positive: 0 | Positive: 0 | No effects: 0 | Positive: 0 | Negative: 148 |
| Patient–physician relationship | No effects: 0 | Positive: 135 | Negative: 0 | No effects: 0 | Positive: 135* | Negative: 0 |
| Value of doctor’s opinion | No effects: 0 | Positive: 161 | Negative: 0 | No effects: 0 | Positive: 0 | Negative: 0 |
| Patient–physician communication | No effects: 0 | Positive: 167* | Negative: 0 | No effects: 3 | Positive: 250,64* | Negative: 0 |
| Received right amount of support | No effects: 0 | Positive: 0 | Negative: 0 | No effects: 0 | Positive: 148 | Negative: 0 |
| Being able to ask questions | No effects: 0 | Positive: 0 | Negative: 0 | No effects: 0 | Positive: 110 | Negative: 0 |
| Self-efficacy in patient–physician interaction | No effects: 0 | Positive: 127* | Negative: 0 | No effects: 0 | Positive: 150 | Negative: 0 |
| Understanding information | No effects: 1 | Positive: 0 | Negative: 0 | No effects: 0 | Positive: 110 | Negative: 0 |
| Sufficient information given | No effects: 0 | Positive: 0 | Negative: 0 | No effects: 1 | Positive: 155* | Negative: 0 |
| Perceived self-efficacy (learning about medication) | No effects: 0 | Positive: 129 | Negative: 0 | No effects: 0 | Positive: 0 | Negative: 0 |
| Perceived self-efficacy (taking medication) | No effects: 0 | Positive: 327,29,69 | Negative: 0 | No effects: 0 | Positive: 0 | Negative: 0 |
| Practical problems | No effects: 0 | Positive: 0 | Negative: 129 | No effects: 0 | Positive: 0 | Negative: 0 |
| Psychosocial variables – related to breast cancer | ||||||
| Fear of cancer recurrence | No effects: 3 | Positive: 0 | Negative: 0 | No effects: 0 | Positive: 210,55* | Negative: 0 |
| High coherence beliefs | No effects: 0 | Positive: 146 | Negative: 0 | No effects: 0 | Positive: 0 | Negative: 0 |
| Personal control, illness consequences | No effects: 1 | Positive: 0 | Negative: 0 | No effects: 0 | Positive: 0 | Negative: 0 |
| Treatment control | No effects: 0 | Positive: 146* | Negative: 0 | No effects: 0 | Positive: 0 | Negative: 0 |
| Perceived agism in cancer care | No effects: 0 | Positive: 0 | Negative: 0 | No effects: 0 | Positive: 0 | Negative: 164* |
| General psychosocial variables | ||||||
| Quality of life/emotional health | No effects: 2 | Positive: 0 | Negative: 140* | No effects: 5 | Positive: 0 | Negative: 0 |
| Optimism | No effects: 0 | Positive: 0 | Negative: 0 | No effects: 0 | Positive: 164* | Negative: 0 |
| Fatalism | No effects: 0 | Positive: 0 | Negative: 0 | No effects: 1 | Positive: 0 | Negative: 0 |
| Anxiety | No effects: 4 | Positive: 0 | Negative: 140* | No effects: 1 | Positive: 0 | Negative: 149 |
| Depression | No effects: 3 | Positive: 0 | Negative: 334,40*,41* | No effects: 5 | Positive: 243,44 | Negative: 135 |
| Low social support | No effects: 1 | Positive: 0 | Negative: 0 | No effects: 0 | Positive: 0 | Negative: 310,64*,70 |
| Cognitive impairments | No effects: 0 | Positive: 0 | Negative: 0 | No effects: 2 | Positive: 0 | Negative: 154 |
| Expressing a desire for future fertility | No effects: 0 | Positive: 0 | Negative: 0 | No effects: 0 | Positive: 0 | Negative: 165 |
Note:
*
The effect was not significant in multivariate analysis or was not tested in multivariate analysis.
Abbreviations: AIs, aromatase inhibitors; BCS, breast-conserving surgery; BMI, body mass index; HR, hormone receptor; HT, hormone therapy; SES, socioeconomic status; TAM, tamoxifen.