Table 2:

Intervention Type and Study Design with Results

Author	Intervention Type	Type of Manipulation	Measure	Design	Results
Arriola, 201438	Communication	physician communication frequency	SR	Cross sectional	S - Frequency of physician communication was significantly associated with medication adherence (p < 0.05)
Lin, 201744	Communication	Patient provider communication	SR	Cross sectional	NS - Endocrine therapy adherence was not associated (p > .05) with physician communications although the majority of the patients reported positive physician communications.
Castaldi, 201746	Patient Navigation	Multi-disciplinary Patient Navigation program vs. SC	Other	non-randomized historical usual care versus navigated care	S - Navigation Program clearly demonstrated improved compliance with follow-up and adjuvant therapy in a predominantly minority population. Compliance for NQF measure 1 in NC is 100% versus 57.1% in UC (P = .005). Compliance for NQF measure 2 in NC is 100% versus 68.6% in UC (P < .0001).
Liu, 201337	Communication	patient-provider communication	SR	Observational	S- The use of endocrine therapy 3 years after diagnosis was positively predicted (AOR = 1.22, P = 0.006) by women’s report that their oncologist used patient-centered communication which was assessed at 18 months after diagnosis.
Kahn, 200742	Communication	patient-centered care	SR & other	prospective cohort	S - Tamoxifen use was significantly higher (P = 0.0051) in those women who reported receiving the right amount of support (79%). Adherence was lower when women (81%) were less satifasfied with decision making role (P = 0.0001) and when decision made alone (56%) (P =0.0003). Adherence lower (P < 0.0001) in women who were not informed about side effects prior to experiencing them (62% vs. 85%)
Heisig, 201543	Education	SC versus enhanced education (printed materials & verbal instruction)	Other	Prospective single cohort	S - Adherence significant for satisfaction with ET information (ρ = 0.17, OR 1.55 p = 0.03, n = 133) and associated problems (ρ = 0.22, OR 1.77, p = 0.006)
Yu, 201239	Support group	SC versus standard treatment plus patient support program group	Other	prospective, controlled, observational	NS - Patients in the standard care group stopped use of endocrine therapy at 213.2 days and in the intervention group at 227.8 days; there was no significant difference in the length of time for discontinuation (P = 0.96).
Neuner, 201545	Financial	Amount Copay	Other	quasi-experimental pre-post	S - Generic anastrozole introduction increased increased probabilty of adherence by 5.4 % and with letrozole/exemestane 11 % higher probability
Hadji, 201340	Education	SC versus educational materials	SR & Other	RCT	NS- no difference in rates between the standard and EM arms (50.9% and 52.3%, respectively, P = 0.37).
Markopoulos, 2015	Education	Educational materials versus SC	SR & Other	RCT	NS- end of study results (CARIATIDE) Educational materials did not signiificantly impact adherence in any country.
Neven, 2014	Education	Educational materials versus standard	SR	RCT	S by country - Year 1 Results (CARIATIDE): Educational materials only improved overall adherence with AI in Sweden/Finland; (p = 0.0246)
Ziller, 2013	Education	reminder letters, information booklets versus reminder letter, telephone calls versus SC	SR and Other	RCT, 3 arms, partially- blinded parallel group	NS - No differences were found in adherence at one year post treatment initiation among control group (48.0%) letter group 64.7% or phone call group 62.7%. Post hoc analysis of combined intervention groups versus control was significantly different (p = 0.039).
Jacob, 2015	Education	disease management program versus SC	Other	retrospective	S - DMP patients vs SC showed significant difference (p=0.001) in discontinuing endocrine therapy within 3 years (32.7 % versus 39.6 %). Risk for discontinuing endocrine therapy was lower in DMP patients than standard care (adjusted HR = 0.91, 95 % CI: 0.85–0.98).
Kostev, 2013	Financial	conversion vs no rebate conversion	Other	retrospective	NS - Switching patients to a rebate pharmaceutical process had a significantly negative effect on adherence at one year and 3 years. Discontinuation of treatment was significantly higher at three years (HR:1.27, CI: 1.05 – 1.53, p = 0.014) 44.2% of women who used a rebate process and 33.8% of patients who continued with same process discontinued their treatment (p < 0.01) after one year.
Neugut, 201136	Education	co-payment amount	Other	Retrospective cohort	S - In younger women, the amount of a 90-day co-payment ($90 or more) was significantly associated with non-adherence when compared to a co-payment of $30 (OR= 0.82; 95% CI, 0.72 to 0.94). Older women had similar negative findings regarding the co-payment amounts of $30 or more compared with co-payment amounts of less than $30 OR= 0.72=95% CI, 0.65 −0.80) respectively.
Albert, 201147	Patient Navigation	patient’s interaction with the breast care nurse	SR	retrospective descriptive	S - Adherence was significantly correlated (p < 0.001) with nurse navigator contact (79 contact vs. 56% no contact) and knowledge of hormone receptor status

Abbreviations: SC, standard care; Tam, tamoxifen; AI, Aromatase inhibitors; RCT, randomized controlled trial; CI, confidence interval; OR, odds ratio; ET endocrine therapy; AOR, adjusted odds ratio; S, significant, NS, not significant