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      Predicting Adherence to Aromatase Inhibitor Therapy among Breast Cancer Survivors: An Application of the Protection Motivation Theory

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          Abstract

          The purpose of this observational study was to determine if the Protection Motivation Theory could predict and explain adherence to aromatase inhibitor (AI) therapy among breast cancer survivors. Purposive sampling was used to identify 288 survivors who had been prescribed AI therapy. A valid and reliable survey was mailed to survivors. A total of 145 survivors completed the survey.

          The Morisky scale was used to measure adherence to AI. The survivors reported a mean score of 6.84 (±0.66) on the scale. Nearly 4 in 10 survivors (38%) were non-adherent. Adherence differed by age, marital status, insurance status, income, and presence of co-morbid conditions. Self-efficacy (r=0.485), protection motivation (r=0.310), and Response Efficacy (r=0.206) were positively and significantly correlated with adherence. Response Cost (r=−0.235) was negatively correlated with adherence. The coping appraisal constructs were statistically significant predictors medication adherence (β=0.437) with self-efficacy being the strongest significant predictor of adherence (β = 0.429).

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          A Protection Motivation Theory of Fear Appeals and Attitude Change1

          RONALD ROGERS (2010)
          A protection motivation theory is proposed that postulates the three crucial components of a fear appeal to be (a) the magnitude of noxiousness of a depicted event; (b) the probability of that event's occurrence; and (c) the efficacy of a protective response. Each of these communication variables initiates corresponding cognitive appraisal processes that mediate attitude change. The proposed conceptualization is a special case of a more comprehensive theoretical schema: expectancy-value theories. Several suggestions are offered for reinterpreting existing data, designing new types of empirical research, and making future studies more comparable. Finally, the principal advantages of protection motivation theory over the rival formulations of Janis and Leventhal are discussed.
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            Adherence to long-term therapies: evidence for action.

            Sabina De Geest, Eduardo Sabate (2004)
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              Predictive validity of a medication adherence measure in an outpatient setting.

              Donald E. Morisky, Alfonso Ang, Marie Krousel-Wood … (2008)
              This study examines the psychometric properties and tests the concurrent and predictive validity of a structured, self-reported medication adherence measure in patients with hypertension. The authors also assessed various psychosocial determinants of adherence, such as knowledge, social support, satisfaction with care, and complexity of the medical regimen. A total of 1367 patients participated in the study; mean age was 52.5 years, 40.8% were male, 76.5% were black, 50.8% graduated from high school, 26% were married, and 54.1% had income <$5,000. The 8-item medication adherence scale was reliable (alpha=.83) and significantly associated with blood pressure control (P<.05). Using a cutpoint of <6, the sensitivity of the measure to identify patients with poor blood pressure control was estimated to be 93%, and the specificity was 53%. The medication adherence measure proved to be reliable, with good concurrent and predictive validity in primarily low-income, minority patients with hypertension and might function as a screening tool in outpatient settings with other patient groups.
              Article 0 comments Cited 347 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Breast Cancer (Auckl)
                Journal ID (iso-abbrev): Breast Cancer (Auckl)
                Journal ID (publisher-id): Breast Cancer: Basic and Clinical Research
                Title: Breast Cancer : Basic and Clinical Research
                Publisher: SAGE Publications (Sage UK: London, England )
                ISSN (Electronic): 1178-2234
                Publication date Collection: 2017
                Publication date (Electronic): 02 March 2017
                Volume: 11
                Electronic Location Identifier: 1178223417694520
                Affiliations
                [1 ]School of Population Health, University of Toledo, Toledo, Ohio, USA.
                [2 ]Department of Pharmacy Practice, University of Toledo, Toledo, Ohio, USA.
                [3 ]Department of Medicine, University of Toledo, Toledo, Ohio, USA.
                Author notes
                CORRESPONDING AUTHOR: Monita Karmakar, School of Population Health, College of Health and Human Services, University of Toledo, 2801 W. Bancroft St, MS 119, Toledo, OH 43606, USA. Email Monita.karmakar@ 123456rockets.utoledo.edu
                Article
                Publisher ID: 10.1177_1178223417694520
                DOI: 10.1177/1178223417694520
                PMC ID: 5391055
                PubMed ID: 28469437
                SO-VID: 26fad113-6073-40ea-ba03-adee87abc5cf
                Copyright © © The Author(s) 2017
                License:

                This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License ( http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page( https://us.sagepub.com/en-us/nam/open-access-at-sage).

                History
                Date received : 23 June 2016
                Date accepted : 18 November 2016
                Categories
                Subject: Original Research

                ScienceOpen disciplines: Oncology & Radiotherapy
                Keywords: breast cancer,survivorship,medication adherence,aromatase inhibitors
                Data availability:
                ScienceOpen disciplines: Oncology & Radiotherapy
                Keywords: breast cancer, survivorship, medication adherence, aromatase inhibitors

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