141st APHA Annual Meeting and Exposition

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286164
Medication adherence among breast cancer survivors: Predictive validity of the protection motivation theory


Sunday, November 3, 2013

Monita Karmakar, M.S. , Ph.D. student, Department of Neurology, University of Toledo, Toledo, OH
Timothy R. Jordan, PhD, MEd, Department of Public Health, College of Health Science & Human Service, University of Toledo, Toledo, OH
Sharrel Pinto, B.S.Pharm, D.M.M., M.S., PhD, Department of Pharmacy Practice, The University of Toledo College of Pharmacy, Toledo, OH
Iman Mohamed, MD, Division of Hematology/Oncology, The University of Toledo Medical Center, Toledo, OH
Monica Holiday - Godman, RPh, PhD, Department of Pharmacy Practice, The University of Toledo College of Pharmacy, Toledo, OH
Background: Poor adherence to adjuvant hormonal therapy is a problem among many breast cancer survivors and increases their odds of cancer recurrence and mortality.

Objective: To examine the predictive validity of Protection Motivation Theory (PMT) to assess adherence to aromatase inhibitors among breast cancer survivors.

Methods: A valid, reliable questionnaire was mailed to 288 breast cancer patients enrolled at a University-based medical center. The Morisky Medication Adherence Scale (MMAS) was used to measure survivors' medication adherence. 145 patients returned completed surveys (response rate to a 54%).

Results: 38% of the survivors were non-adherent to their medications including six who had discontinued therapy against doctors' orders. The level of protection motivation was positively and significantly correlated with adherence (r=0.310). Multiple regression revealed that coping appraisal was a better predictor of adherence (β=0.437) than threat appraisal, which was not correlated with adherence. Pearson's Correlation revealed that the PMT constructs of self-efficacy (r=0.485) and response efficacy (r=0.206) were positively correlated with adherence while response cost (r=-0.235) showed a negative correlation. Among the individual constructs of the PMT, self-efficacy was the only significant predictor of adherence (β = 0.429).

Conclusion: The coping appraisal portion of the PMT was useful in explaining breast cancer survivors' medication adherence. Those who work with survivors should consider using this PMT construct in their patient education and materials.

Learning Areas:

Chronic disease management and prevention
Other professions or practice related to public health
Public health or related education
Public health or related research
Social and behavioral sciences
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
Describe the constructs of the Protection Motivation Theory (PMT) in relation to breast cancer recurrence. Describe how the constructs of the PMT explain breast cancer survivors’ motivation and adherence to Aromatase Inhibitors. Explain how to use the constructs of the PMT in communication with and programs to improve medication adherence breast cancer survivors.

Keyword(s): Adherence, Breast Cancer

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a doctoral student in the Health Education program at the University of Toledo. This project entitled "Medication adherence among breast cancer survivors: Predictive validity of the protection motivation theory" is a part of my thesis project for my masters degree in Pharmacy Administration.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 2047.0: Innovative research on cancer prevention and control among women: Confronting and eliminating disparities (a joint session of the Cancer Forum and Women’s Caucus)