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.