Aromatase inhibitor ; Breast cancer ; Medication adherence ; Musculoskeletal pain
Abstract
Purpose: Aromatase inhibitors (AIs) are widely prescribed for postmenopausal women with breast
cancer and are known to cause musculoskeletal pain. This study aimed to identify factors associated
with AI continuation intention among breast cancer survivors (BCS).
Methods: A cross-sectional survey was conducted on 123 BCS (stages I–III), who had been taking
AIs for at least 6 weeks. Participants were recruited from a cancer center in Goyang, Korea, from
September to November 2019. Descriptive statistics, Welch analysis of variance, Pearson correlation
coefficients, and simple linear regression were used for the analysis.
Results: Beliefs about endocrine therapy was a significant predictor of AI continuation intention
(β=.66, p<.001). The majority of participants (87.0%) reported experiencing musculoskeletal pain
since taking AIs and the score for the worst pain severity within 24 hours was 5.08±2.80 out of 10.
Musculoskeletal pain, however, was not associated with AI continuation intention. Fear of cancer re currence (FCR) was clinically significant (≥13) for 74.0% of the respondents (mean, 17.62±7.14).
Musculoskeletal pain severity and pain interference were significantly associated with FCR (r=.21,
p<.05; r=.35, p<.01, respectively). Pain interference was significantly associated with beliefs about
endocrine therapy (r=–.18, p<.05).
Conclusion: AI continuation intention can be modified by reinforcing patients’ beliefs about endo crine therapy. Musculoskeletal pain may have a negative effect on beliefs about endocrine therapy
and increase FCR among BCS. Thus, awareness of musculoskeletal pain during AI therapy should
be raised and further research is required to develop multidisciplinary pain management strategies
and clinical guidelines to reinforce beliefs about endocrine therapy.