Skip to main content

Research Repository

Advanced Search

The impact of medication side effects on adherence and persistence to hormone therapy in breast cancer survivors: A qualitative systematic review and thematic synthesis

Peddie, Nicola; Agnew, Sommer; Crawford, Megan; Dixon, Diane; MacPherson, Iain; Fleming, Leanne


Nicola Peddie

Sommer Agnew

Megan Crawford

Diane Dixon

Iain MacPherson

Leanne Fleming


Hormone Therapy (HT) reduces the risk of breast cancer recurrence and mortality in women with breast cancer. Despite these clinical benefits, rates of HT non-adherence and non-persistence are high. Research suggests this may be due to the impact of HT side effects. However, little research has explored the individual contribution of side effects to non-adherence and non-persistence behaviours, thereby hindering the implementation of targeted intervention strategies. Our aim is to review the published literature on breast cancer survivors’ lived experiences of HT side effects and explore how these may be related to non-adherence and non-persistence behaviour.
Electronic searches were conducted from inception to May 2020, utilising Cochrane CENTRAL, Medline, Embase, Web of Science and PsycINFO databases. Searches included a combination of terms related to breast cancer, adherence, hormone therapy and side effects.
Sixteen eligible papers were identified, and study quality was high. Data were thematically synthesised into four analytical themes, which encompassed 13 descriptive sub-themes: ‘Daily impact of side-effects’, ‘Role of Health Care Professionals’, ‘Managing HT side-effects’, and ‘Weighing up the pros and cons’.
HT side effects significantly impact breast cancer survivor's quality of life. A lack of support from healthcare providers leads to self-management strategies, which negatively affects adherence and persistence behaviour.

Journal Article Type Review
Acceptance Date May 13, 2021
Online Publication Date May 17, 2021
Publication Date 2021-08
Deposit Date Feb 13, 2023
Publicly Available Date Feb 13, 2023
Print ISSN 0960-9776
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 58
Pages 147-159
Keywords Adjuvant hormone therapy, Breast cancer, Side effects, Endocrine therapy, Tamoxifen, Aromatase inhibitor, Adherence, Persistence, Qualitative


You might also like

Downloadable Citations