In particular, the musculoskeletal effects of AIs prompted discontinuation in more than 10% of women in one study. “Information support for patients about anticipated adverse effects and management of those adverse effects may increase persistence,” according to the guideline.
Monetary constraints are another cause of nonadherence. In one study of tamoxifen, 60% of patients who discontinued treatment early said that the cost of the drug was a key factor. “It is likely that the out-of-pocket costs of AIs pose an even greater barrier to patients,” the committee said.
Disclosures: Some of the update committee members reported ties to Pfizer, Novartis, and AstraZeneca.