[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-181799-105":3,"detail-sidebar-cat-0-en-105":85,"doc-detail-181799-en":134},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":78,"head_meta":80,"extra_data":82,"updated_unix":84},105,"en","group-based-trajectory-modeling-to-identify-patterns-of-oral-endocrine-therapy-adherence-in-breast-cancer","Group-Based Trajectory Modeling to Identify Patterns of Oral Endocrine Therapy Adherence in Breast Cancer","","Poor adherence to oral endocrine therapy (OET) is common among patients with hormone receptor–positive breast cancer and is linked to increased recurrence and mortality. Non-adherence is especially prevalent in underserved patients due to socioeconomic barriers and limited access to care. A single-center retrospective study assessed OET adherence over time using group-based trajectory modeling (GBTM) and proportion of days covered (PDC) among patients at Harris Health System in Houston.",{"@graph":14,"@context":77},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/research-report/","Research & Report",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/group-based-trajectory-modeling-to-identify-patterns-of-oral-endocrine-therapy-adherence-in-breast-cancer/181799/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/group-based-trajectory-modeling-to-identify-patterns-of-oral-endocrine-therapy-adherence-in-breast-cancer/181799.png","ImageObject",300,407,{"name":42,"@type":43},"Valentina","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-17","2026-09-02",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",9,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69,73],{"name":60,"@type":61,"acceptedAnswer":62},"What problem does the study address regarding oral endocrine therapy (OET)?","Question",{"text":63,"@type":64},"The study addresses poor adherence to OET in hormone receptor–positive breast cancer, which increases the risk of recurrence and mortality. It focuses on how non-adherence is more common in underserved patients due to socioeconomic factors and limited healthcare access.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"How was OET adherence measured and modeled over time?",{"text":68,"@type":64},"Adherence was measured using proportion of days covered (PDC). Group-based trajectory modeling (GBTM) was used to identify distinct adherence groups over time, followed by multinomial logistic regression to evaluate predictors of non-adherence trajectories.",{"name":70,"@type":61,"acceptedAnswer":71},"What adherence trajectories were identified among the 496 patients?",{"text":72,"@type":64},"Four trajectories were identified: consistent high adherence (41.4%), constant PDC at approximately 0.6 (32.6%), rapid decline (14.6%), and low adherence with gradual decline (11.5%).",{"name":74,"@type":61,"acceptedAnswer":75},"Which predictors were associated with worse OET adherence trajectories?",{"text":76,"@type":64},"African American patients had higher likelihood of low adherence with gradual decline. Diabetes was associated with higher likelihood of constant PDC at approximately 0.6, and longer time on therapy (≥4 years) predicted both low adherence with gradual decline and constant PDC at approximately 0.6.","https://schema.org",{"og:url":32,"og:type":79,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":81,"canonical":32},"index,follow",{"doc_id":83,"site_id":7},181799,1788345971,{"code":4,"msg":86,"data":87},"success",[88,92,96,100,105,110,115,119,123,126,130],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":97,"show_sort_weight":98,"slug":99},"Exam",70,"exam",{"id":101,"doc_module":4,"doc_module_name":25,"category_name":102,"show_sort_weight":103,"slug":104},5,"Comic",60,"comic",{"id":106,"doc_module":4,"doc_module_name":25,"category_name":107,"show_sort_weight":108,"slug":109},6,"Technology",50,"technology",{"id":111,"doc_module":4,"doc_module_name":25,"category_name":112,"show_sort_weight":113,"slug":114},7,"Healthcare",40,"healthcare",{"id":116,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":117,"slug":118},8,30,"research-report",{"id":55,"doc_module":4,"doc_module_name":25,"category_name":120,"show_sort_weight":121,"slug":122},"Religion & Spirituality",20,"religion-spirituality",{"id":121,"doc_module":4,"doc_module_name":25,"category_name":124,"show_sort_weight":121,"slug":125},"World Cup","world-cup",{"id":127,"doc_module":4,"doc_module_name":25,"category_name":128,"show_sort_weight":127,"slug":129},10,"Lifestyle","lifestyle",{"id":131,"doc_module":4,"doc_module_name":25,"category_name":132,"show_sort_weight":101,"slug":133},19,"General","general",{"code":4,"msg":86,"data":135},{"doc_id":83,"user_id":136,"nickname":42,"user_avatar":137,"doc_module":4,"category_id":116,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":138,"file_id":139,"file_url":140,"file_type":141,"file_size":142,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":143,"language":144,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":145,"faqs":146,"seo_title":147,"seo_description":12,"update_tm":84,"read_time":117,"preview_page_count":4},13056703020460,"https://ap-avatar.wpscdn.com/avatar/be000253dac470eee5d?_k=1778207105932848923","| Background: Poor adherence to oral endocrine therapy (OET) is a significant problem among patients with hormone receptorpositive breast cancer as it results in higher risk of recurrence and mortality. Non-adherence to OET is prevalent among underserved patients, often attributable to socioeconomic factors and limited healthcare access. We evaluated OET adherence patterns over time using group-based trajectory modeling (GBTM) and identified predictors of suboptimal adherence trajectory among patients seen at Harris Health System, serving underserved patients in Houston, Texas.\u003Cbr>Methods: A single-center, retrospective study was conducted from October 2019 through December 2020. OET adherence was measured using proportion of days covered (PDC) . A logistic GBTM was conducted using 2–5 adherence groups considering the Bayesian information criteria, clinical relevance, and a 5% minimum membership requirement. Multinomial logistic regression was used to assess the predictors of non-adherence trajectories.\u003Cbr>Results: Among 496 patients, majority were Hispanic (62.50%) or African American (15.12%) and \u003C65 years of age (82.66%) . Four distinct adherence trajectories were identified: consistent high adherence (41.4%); constant PDC at ~0.6 (32.6%); rapid decline (14.6%); low adherence with gradual decline (11.5%). African Americans had higher likelihood of having low adherence with gradual decline [odds ratio (OR): 2.462 (confidence interval (CI): 1.1149–5.276), p=0.0205] . Patients with diabetes were more likely to have constant PDC at ~0.6 [OR: 1.714 (CI: 1.042–2.820), p=0.0338] . Longer time (4 or greater years) on therapy predicted low adherence with gradual decline [OR: 2.463 (CI: 1.266–4.793), p=0.008) and constant PDC at ~0.6 (OR: 1.966 (CI: 1.141–3.388), p=0.0149] trajectories.\u003Cbr>Conclusion: The identified predictors, including comorbidities like diabetes, African American descent, and longer OET treatment are crucial considerations when developing patient-centered interventions to enhance OET adherence among underserved populations. These insights can guide the implementation of initiatives such as mobile health applications, community-based educational programs, and financial aid efforts.\u003Cbr>Keywords: oral endocrine therapy, breast cancer, medication adherence, group-based trajectory modeling, minority, underserved |\n| --- |\n| Introduction\u003Cbr>Breast cancer (BC) is the most common cancer among women in the United States (US) excluding skin cancers.1–3 In 2023, 297,790 women are expected to be diagnosed with invasive BC and 43,170 women are expected to have noninvasive BC.4 Over 70% of BC cases are hormone (estrogen and/or progesterone) receptor positive (HR+) .5 Patients diagnosed with early-stage HR+ BC are treated with oral endocrine therapies (OET), which consists of tamoxifen, |\n\n| Variable | Low Adherence with Gradual Decline (N=73) | Rapid Decline (N=57) | Consistent High Adherence (N=203) | Constant PDC\u003Cbr>at ~0.6 (N=163) | Total (N=496) | P-value |\n| --- | --- | --- | --- | --- | --- | --- |\n| Age |  |  |  |  |  |  |\n| \u003C65 | 61 (83.6) | 44 (77.2) | 166 (81.8) | 139 (85.3) | 410 (82.7) | 0.5479 |\n| ≥65 | 12 (16.4) | 13 (22.8) | 37 (18.2) | 24 (14.7) | 86 (17.3) |  |\n| Race/ethnicity |  |  |  |  |  |  |\n| AA | 17 (23.3) | 9 (15.8) | 26 (12.8) | 23 (14.1) | 75 (15.1) | 0.1799 |\n| Hispanic | 39 (53.4) | 32 (56.1) | 128 (63.1) | 111 (68.1) | 310 (62.5) |  |\n| White/NH & others | 17 (23.3) | 16 (28.1) | 49 (24.1) | 29 (17.8) | 111 (22.4) |  |\n| Gender |  |  |  |  |  |  |\n| Male | Not included in analysis |  |  |  | 1 (0.2) | NA |\n| Female |  |  |  |  | 495 (99.8) |  |\n| Hyperlipidemia |  |  |  |  |  |  |\n| Yes | 46 (63.0) | 30 (52.6) | 100 (49.3) | 66 (40.5) | 242 (48.8) | 0.0131 |\n| No | 27 (37.0) | 27 (47.4) | 103 (50.7) | 97 (59.5) | 254 (51.2) |  |\n| Hypertension |  |  |  |  |  |  |\n| Yes | 46 (63.0) | 30 (52.6) | 128 (63.1) | 77 (47.2) | 281 (56.7) | 0.0126 |\n| No | 27 (37.0) | 27 (47.4) | 75 (36.9) | 86 (57.8) | 21","cbCaiixgEV0KCP35","https://ap.wps.com/l/cbCaiixgEV0KCP35","pdf",1271923,12,"English","# Introduction\n## Background and problem statement\n## Study approach overview\n# Methods\n## Study design and setting\n## Adherence measurement\n## Statistical modeling and predictors\n# Results\n## Patient characteristics\n## Identified adherence trajectories\n## Predictors of suboptimal trajectories\n# Conclusion\n## Implications for interventions\n## Potential implementation ideas","[{\"question\":\"What problem does the study address regarding oral endocrine therapy (OET)?\",\"answer\":\"The study addresses poor adherence to OET in hormone receptor–positive breast cancer, which increases the risk of recurrence and mortality. It focuses on how non-adherence is more common in underserved patients due to socioeconomic factors and limited healthcare access.\"},{\"question\":\"How was OET adherence measured and modeled over time?\",\"answer\":\"Adherence was measured using proportion of days covered (PDC). Group-based trajectory modeling (GBTM) was used to identify distinct adherence groups over time, followed by multinomial logistic regression to evaluate predictors of non-adherence trajectories.\"},{\"question\":\"What adherence trajectories were identified among the 496 patients?\",\"answer\":\"Four trajectories were identified: consistent high adherence (41.4%), constant PDC at approximately 0.6 (32.6%), rapid decline (14.6%), and low adherence with gradual decline (11.5%).\"},{\"question\":\"Which predictors were associated with worse OET adherence trajectories?\",\"answer\":\"African American patients had higher likelihood of low adherence with gradual decline. Diabetes was associated with higher likelihood of constant PDC at approximately 0.6, and longer time on therapy (≥4 years) predicted both low adherence with gradual decline and constant PDC at approximately 0.6.\"}]","Group-Based Trajectory Modeling to Identify Patterns of Oral Endocrine Therapy Adherence in Breast Cancer | PDF"]