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Research Studies is a monthly compilation of research articles funded by AHRQ or authored by AHRQ researchers and recently published in journals or newsletters.

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1 to 9 of 9 Research Studies Displayed
Farias AJ, Wu WH, Du XL
Racial differences in long-term adjuvant endocrine therapy adherence and mortality among Medicaid-insured breast cancer patients in Texas: findings from TCR-Medicaid linked data.
There are racial/ethnic disparities in breast cancer mortality that may be attributed to differences in receipt of adjuvant cancer treatment. The purpose of this article was to determine whether the mortality disparities could be explained by racial/ethnic differences in long-term adherence to adjuvant endocrine therapy (AET). The investigators concluded that long-term adherence in the Medicaid population was suboptimal and racial/ethnic differences in AET adherence may partially explain disparities in mortality.
AHRQ-funded; HS018956.
Citation: Farias AJ, Wu WH, Du XL . Racial differences in long-term adjuvant endocrine therapy adherence and mortality among Medicaid-insured breast cancer patients in Texas: findings from TCR-Medicaid linked data. BMC Cancer 2018 Dec 4;18(1):1214. doi: 10.1186/s12885-018-5121-z..
View abstract on the National Library of Medicine site.
Keywords: Cancer: Breast Cancer, Disparities, Medicaid, Patient Adherence/Compliance, Racial / Ethnic Minorities
Farias AJ, Wu WH, Du XL
Racial and geographic disparities in adherence and discontinuation to adjuvant endocrine therapy in Texas Medicaid-insured patients with breast cancer.
The purpose of the study is to examine disparities in adjuvant endocrine therapy (AET) adherence and discontinuation among Texas Medicaid-insured early-stage breast cancer patients. The studies concluded that patients from the Texas/Mexico border had higher odds of adherence compared to other regions. There are substantial racial and geographic disparities in AET adherence and discontinuation among Texas Medicaid-insured women.
AHRQ-funded; HS018956.
Citation: Farias AJ, Wu WH, Du XL . Racial and geographic disparities in adherence and discontinuation to adjuvant endocrine therapy in Texas Medicaid-insured patients with breast cancer. Med Oncol 2018 Jun 20;35(7):113. doi: 10.1007/s12032-018-1168-6..
View abstract on the National Library of Medicine site.
Keywords: Cancer: Breast Cancer, Disparities, Medicaid, Patient Adherence/Compliance, Racial / Ethnic Minorities
Milata JL, Otte JL, Carpenter JS
Oral endocrine therapy nonadherence, adverse effects, decisional support, and decisional needs in women with breast cancer.
Adverse effects contribute to breast cancer survivors’ decisions to stop oral endocrine therapy (OET), yet there has been little investigation of the process through which that occurs. This review serves as a call to action for providers to provide support to breast cancer survivors experiencing OET adverse effects and facing decisions related to nonadherence.

AHRQ-funded; HS024241.
Citation: Milata JL, Otte JL, Carpenter JS . Oral endocrine therapy nonadherence, adverse effects, decisional support, and decisional needs in women with breast cancer. Cancer Nurs 2018 Jan/Feb;41(1):E9-E18. doi: 10.1097/ncc.0000000000000430..
View abstract on the National Library of Medicine site.
Keywords: Adverse Events, Cancer: Breast Cancer, Decision Making, Medication, Patient Adherence/Compliance
Farias AJ, Du XL
Association between out-of-pocket costs, race/ethnicity, and adjuvant endocrine therapy adherence among Medicare patients with breast cancer.
This study aimed to determine whether there are racial/ethnic differences in 1-year adherence to adjuvant endocrine therapy (AET) and whether out-of-pocket costs explain the racial/ethnic disparities in adherence. It concluded that racial/ethnic disparities in AET adherence were largely explained by women's differences in socioeconomic status and out-of-pocket medication costs.
AHRQ-funded; HS018956.
Citation: Farias AJ, Du XL . Association between out-of-pocket costs, race/ethnicity, and adjuvant endocrine therapy adherence among Medicare patients with breast cancer. J Clin Oncol 2017 Jan;35(1):86-95.
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View abstract on the National Library of Medicine site.
Keywords: Cancer: Breast Cancer, Healthcare Costs, Patient Adherence/Compliance, Racial / Ethnic Minorities, Social Determinants of Health
Highfield L, Rajan SS, Valerio MA
A non-randomized controlled stepped wedge trial to evaluate the effectiveness of a multi-level mammography intervention in improving appointment adherence in underserved women.
This study evaluated a theoretically based, systematically designed implementation strategy to support adoption and implementation of a patient navigation-based intervention, called Peace of Mind Program (PMP), aimed at improving breast cancer screening among underserved women.. Any potential confounding or bias will be controlled in the analysis. Outcomes such as appointment adherence, patient referral to diagnostics, time to diagnostic referral, patient referral to treatment, time to treatment referral, and budget impact of the intervention will be assessed.
AHRQ-funded; HS023255.
Citation: Highfield L, Rajan SS, Valerio MA . A non-randomized controlled stepped wedge trial to evaluate the effectiveness of a multi-level mammography intervention in improving appointment adherence in underserved women. Implement Sci 2015 Oct 14;10:143. doi: 10.1186/s13012-015-0334-x.
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View abstract on the National Library of Medicine site.
Keywords: Cancer: Breast Cancer, Cancer, Mammogram, Screening, Patient Adherence/Compliance, Vulnerable Populations, Safety Net, Prevention, Women, Imaging
Rosenberg SM, Partridge AH
New insights into nonadherence with adjuvant endocrine therapy among young women with breast cancer.
This editorial described endocrine therapy and reasons for nonadherence in young women with breast cancer, including side effects and fertility concerns.
AHRQ-funded; HS023680.
Citation: Rosenberg SM, Partridge AH . New insights into nonadherence with adjuvant endocrine therapy among young women with breast cancer. J Natl Cancer Inst 2015 Oct;107(10). doi: 10.1093/jnci/djv245.
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View abstract on the National Library of Medicine site.
Keywords: Adverse Drug Events (ADE), Cancer: Breast Cancer, Medication, Patient Adherence/Compliance
Roberts MC, Wheeler SB, Reeder-Hayes K
Racial/Ethnic and socioeconomic disparities in endocrine therapy adherence in breast cancer: a systematic review.
The authors sought to understand factors that influence endocrine therapy (ET) adherence among racial/ethnic and socioeconomic subpopulations of breast cancer patients. They found significant underuse of ET among minority and low-income women. They further noted that both race/ethnicity and socioeconomic status are associated with ET use in most settings.
AHRQ-funded; HS021282.
Citation: Roberts MC, Wheeler SB, Reeder-Hayes K . Racial/Ethnic and socioeconomic disparities in endocrine therapy adherence in breast cancer: a systematic review. Am J Public Health 2015 Jul;105 Suppl 3:e4-e15. doi: 10.2105/ajph.2014.302490.
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View abstract on the National Library of Medicine site.
Keywords: Cancer: Breast Cancer, Medication, Patient Adherence/Compliance, Racial / Ethnic Minorities, Social Determinants of Health
Wang X, Du XL
Socio-demographic and geographic variations in the utilization of hormone therapy in older women with breast cancer after Medicare Part-D coverage.
The researchers assessed socio-demographic, geographic, and other variations in the receipt of hormone therapy among patients with hormone receptor-positive breast cancer as well as adherence to hormone therapy within 1-year follow-up. They found that found that increasing age was significantly associated with a decreased receipt of hormone therapy and aromatase inhibitors in all hormone receptor-positive breast cancer patients after adjusting for other factors regardless of whether chemotherapy was received.
AHRQ-funded; HS018956.
Citation: Wang X, Du XL . Socio-demographic and geographic variations in the utilization of hormone therapy in older women with breast cancer after Medicare Part-D coverage. Med Oncol 2015 May;32(5):154. doi: 10.1007/s12032-015-0599-6..
View abstract on the National Library of Medicine site.
Keywords: Cancer: Breast Cancer, Healthcare Utilization, Patient Adherence/Compliance, Patient-Centered Outcomes Research, Social Determinants of Health
Pan IW, Smith BD, Shih YC
Factors contributing to underuse of radiation among younger women with breast cancer.
This study explores factors associated with noncompliance of RT among insured young patients. It found that competing demands from child care, especially the presence of a young child in the home, can constitute a barrier to complete guideline-concordant breast cancer therapy.
AHRQ-funded; HS018535.
Citation: Pan IW, Smith BD, Shih YC . Factors contributing to underuse of radiation among younger women with breast cancer. J Natl Cancer Inst 2014 Jan;106(1):djt340. doi: 10.1093/jnci/djt340..
View abstract on the National Library of Medicine site.
Keywords: Cancer: Breast Cancer, Health Insurance, Patient Adherence/Compliance, Surgery, Treatments

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