Less than one-third of Appalachian breast cancer survivors continue taking prescribed medicine

About one-third of Appalachian breast cancer survivors stop taking prescribed medicine, despite having insurance that covers the costs, says a study published in the July issue of Medicine. Researchers looked at 428 patients from 2006 to 2008 in Kentucky, North Carolina, Ohio and Pennsylvania, finding that 31 percent "were not adherent to adjuvant endocrine therapy (AET) and 30 percent were not persistent over an average follow-up period of 421 days." Adjuvant drugs are typically used to enhance pain relief from pain medicine in difficult to treat conditions. (Map: Appalachia, as defined by Congress)

Lead author Rajesh Balkrishnan, professor of Public Health Sciences at the University of Virginia School of Medicine, said, “We found that a complex variety of factors including poverty, geography and preventive health orientation affect the health of women with breast cancer in Appalachia."

Patients "receiving catastrophic insurance coverage were three times more likely to adhere to their adjuvant endocrine therapy and also had a 44 percent lower risk of discontinuing therapy," Heather Lindsey reports for Oncology Times. Among the study group, "43 percent of patients were categorized as being economically distressed, 67 percent lived in largely rural environments and 88 percent experienced health care professional shortages."

Some patients stopped taking medication because of doctor shortages or long distances to drive to a pharmacist, Lindsey writes. "Another factor is the amount and type of insurance coverage patients have to cover these costs. While insurance typically covers most adjuvant hormone therapies, people in this study population may be watching every dollar." (Read more)