Recent Publications

Publications from the SWEET programme so far:

Lay summary of articles (known as papers)

• Identifying determinants of adherence to adjuvant endocrine therapy following breast cancer: A systematic review of reviews. Todd et al. 2024. Cancer Medicine. Click here to read

Lay summary:

The use of hormone treatment for certain types of breast cancer has been shown to be beneficial for patients. Despite these benefits, research tells us that some people don’t take their hormone treatment all the time, while some people stop taking it altogether – broadly speaking this is known as non-adherence.
The reasons for non-adherence to hormone treatment in breast cancer are complex and are very much dependent on the individual person and their circumstances. The aim of this paper was to review previous published research papers (known as systematic reviews), to help us understand the reasons why people don’t take their hormone therapy all of the time.
In total, we found 17 reviews – 9 were quantitative (focusing on numerical information), while 4 were qualitative (focusing on how people feel and think about using the treatment), and the remaining 4 focused on both quantitative and qualitative information.
Overall, there were many identified reasons why people are non-adherent. Patient factors (e.g. how important people think the treatment is), and healthcare system/professional factors (e.g. having a positive relationship with the healthcare professional) were the most commonly reported. Other factors included socio-economic factors (e.g. lower levels of social or economic support), medication related factors (e.g. developing side effects), and condition related factors (e.g. the size and extent of the cancer). The results of this paper show us that any new services designed to improve adherence to hormone therapy should address these different factors.

• Development of the HT&Me intervention to support women with breast cancer to adhere to adjuvant endocrine therapy and improve quality of life. Stewart et al. 2023. The Breast. Click here to read

Lay summary:

The HT&Me intervention was created to help women with oestrogen receptor (ER+) positive breast cancer take their hormone therapy, and also improve their overall quality of life. It was created with involvement and input from lots of people with varied backgrounds – including women with breast cancer, researchers and medical experts. HT&Me support includes appointments with a trained nurse, a short video, the HT&Me website, and motivational text/email messages to help women to manage their treatment. We tested this with a small number of women taking hormone therapy for their breast cancer and made improvements based on feedback to ensure that HT&Me is practical and acceptable. We are now testing the HT&Me intervention in future larger studies to see if it works well and is cost effective.

• Informing interventions to improve uptake of adjuvant endocrine therapy in women with breast cancer: a theoretical-based examination of modifiable influences on non-adherence. Cahir et al. 2023. Supportive Cancer Care. Click here to read

Lay summary:

To develop interventions to support women to take their hormone therapy, our research aimed to identify the reasons women may not take their hormone therapy as prescribed. Women aged over 18 years, with a diagnosis of either oestrogen positive (ER+) or progesterone positive (PR+) breast cancer who were prescribed hormone therapy were invited to complete a questionnaire. The questionnaire measured; (i) key social and demographic factors; (ii) possible reasons non-adherence and; (iii) non-adherence to hormone therapy. Women who said they regularly missed doses or who had stopped taking hormone therapy were classified as non-adherent. 1,606 women completed the questionnaire. 395 women (25%) were classified as non-adherent. Feeling that hormone therapy may disrupt their lifestyle, activities and interests was linked to being less likely to believe that taking hormone therapy is necessary and being more likely to expect negative outcomes, leading to non-adherence. Women who reported they were informed about why they were taking hormone therapy, how it works, their risk of side-effects and what to do if they experienced side-effects, were more likely to believe taking hormone therapy is necessary for them, have better use of coping skills and greater adherence. Women without a medication taking routine and who did not perceive their hormone therapy to be necessary/important were more likely to forget to take it.