Table 3:
Prior medication regimen effects on endocrine therapy adherence, by subgroups with and without bipolar and psychotic disorders
| Initiation | aDiscontinuation | bAdherence | |||||
|---|---|---|---|---|---|---|---|
| Bipolar and Psychotic Disorder n=1,259 |
No Diagnosis n=20,635 |
Bipolar and Psychotic Disorder n=951 |
No Diagnosis n=16,561 |
Bipolar and Psychotic Disorder n=951 |
No Diagnosis n=16,561 |
||
| Parameter | Hazard Ratio (95% CI) |
Hazard Ratio (95% CI) |
Hazard Ratio (95% CI) |
Hazard Ratio (95% CI) |
Estimate (95% CI) |
Estimate (95% CI) |
|
| cIntercept | - | - | - | - | **0.711 (0.576, 0.846) | **0.777 (0.757, 0.797) | |
| MRCI-A Route Complexity | 2-4 | 1.00 (0.85-1.16) | *0.96 (0.93-1.00) | 0.94 (0.69-1.27) | *1.08 (1.00-1.16) | 0.007 (−0.018, 0.031) | 0.001 (−0.005, 0.006) |
| (ref= 0-1) | 5+ | 0.97 (0.81-1.17) | 1.00 (0.95-1.06) | 1.00 (0.69-1.44) | *1.14 (1.02-1.26) | 0.016 (−0.013, 0.046) | *0.014 (0.005, 0.022) |
| Overall variable p value | 0.95 | 0.06 | 0.89 | 0.03 | 0.56 | 0.005 | |
| Combined Medication & Visit Score | 1-3 Meds | 0.88 (0.42-1.85) | **1.34 (1.19-1.51) | 1.01 (0.25-4.05) | *0.71 (0.56-0.90) | −0.035 (−0.206, 0.136) | 0.020 (0.000, 0.040) |
| (ref= No Meds) | 4+ Meds or 2+ Visits | 0.87 (0.50-1.50) | **1.37 (1.23-1.52) | 0.78 (0.27-2.22) | **0.56 (0.45-0.70) | 0.032 (−0.089, 0.153) | **0.044 (0.026, 0.061) |
| 4+ Meds & 2+ Visits | 1.07 (0.64-1.78) | **1.47 (1.33-1.64) | 0.64 (0.23-1.73) | **0.49 (0.39-0.61) | 0.063 (−0.051, 0.178) | **0.054 (0.037, 0.072) | |
| Overall variable p value | 0.42 | <0.001 | 0.60 | <0.001 | 0.19 | <0.001 | |
| Out-of-Pocket Medication Costs | $1 < $50 | 1.04 (0.83-1.29) | 0.98 (0.90-1.07) | 1.18 (0.73-1.90) | 1.16 (0.96-1.40) | −0.021 (−0.051, 0.009) | *−0.016 (−0.029, −0.004) |
| (ref= $0 < $1) | $50 < $500 | 0.96 (0.78-1.16) | 0.96 (0.89-1.04) | 1.43 (0.93-2.18) | *1.28 (1.07-1.54) | **−0.069 (−0.098, −0.039) | **−0.036 (−0.048, −0.024) |
| $500+ | *0.73 (0.57-0.93) | *0.88 (0.80-0.97) | 1.36 (0.83-2.23) | 1.22 (1.00-1.50) | **−0.065 (−0.101, −0.030) | **−0.029 (−0.044, −0.015) | |
| Overall variable p value | 0.02 | 0.01 | 0.36 | 0.006 | <0.001 | <0.001 | |
P value *<0.05, **<0.001, 95% confidence interval. Overall variable p value calculated for categorical variables with 3 or more strata. “Combined Medication & Visit” variable created from each variable’s significant response levels in separate adjusted models (Appendix 2). Models adjusted for stage, age, race, ethnicity, NCI comorbidity score, function-related indicators, rurality, mental illness, year of diagnosis (Appendix 3).
Follow-up began the day of endocrine therapy initiation, concluding at censoring or a maximum five years of endocrine therapy use.
Discontinuation analysis censored after five years continuous use.
Adherence measured with the proportion of days covered (PDC), for patients with one or more years of observation with over half of this time outside hospitals and skilled nursing facilities. Estimate of 0.01 corresponds to 1%.
Applicable to adherence only.