Prescription Refill Gap of Endocrine Treatment from Electronic Medical Records as a Prognostic Factor in Breast Cancer Patients
- Author:
Yura LEE
1
;
Yu Rang PARK
;
Ji Sung LEE
;
Sae Byul LEE
;
Il Yong CHUNG
;
Byung Ho SON
;
Sei Hyun AHN
;
Jong Won LEE
Author Information
- Publication Type:Original Article
- Keywords: Breast Neoplasms; Estrogen Antagonists; Medication Adherence; Neoplasm Metastasis
- MeSH: Breast Neoplasms; Breast; Electronic Health Records; Estrogen Antagonists; Humans; Medication Adherence; Neoplasm Metastasis; Prescriptions; Prognosis; Recurrence; Retrospective Studies
- From:Journal of Breast Cancer 2019;22(1):86-95
- CountryRepublic of Korea
- Language:English
- Abstract: PURPOSE: Discontinuation of hormone therapy is known to lead to a poorer prognosis in breast cancer patients. We aimed to investigate the prescription gap as a prompt index of medication adherence by using prescription data extracted from patient electronic medical records. METHODS: A total of 5,928 patients diagnosed with invasive, non-metastatic breast cancer, who underwent surgery from January 1, 1997 to December 31, 2009, were enrolled retrospectively. The prescription data for 4.5 years of hormonal treatment and breast cancer-related events after treatment completion were analyzed. We examined the characteristics and prognoses of breast cancer in patients with and without a 4-week gap. RESULTS: Patients with a gap showed a significantly higher risk of breast cancer recurrence, distant metastasis, breast cancer-specific death, and overall death after adjustment (hazard ratio [HR], 1.389; 95% confidence interval [CI], 1.089–1.772; HR, 1.568; 95% CI, 1.158–2.123; HR, 2.108; 95% CI, 1.298–3.423; and HR, 2.102; 95% CI, 1.456–3.034, respectively). When patients were categorized based on gap summation, the lower third (160 days) and fourth (391 days) quartiles showed a significantly higher risk of distant metastasis (HR, 1.758; 95% CI, 1.186–2.606 and HR, 1.844; 95% CI, 1.262–2.693, respectively). CONCLUSION: A gap of > 4 weeks in hormonal treatment has negative effects on breast cancer prognosis, and can hence be used as a sentinel index of higher risk due to treatment non-adherence. Further evaluation is needed to determine whether the gap can be used as a universal index for monitoring the adherence to hormonal treatment.
