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Annals of Oncology Advance Access originally published online on October 20, 2005
Annals of Oncology 2006 17(2):205-210; doi:10.1093/annonc/mdj044
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© 2005 European Society for Medical Oncology

Patients' preference for administration of endocrine treatments by injection or tablets: results from a study of women with breast cancer

L. Fallowfield*, L. Atkins, S. Catt, A. Cox, C. Coxon, C. Langridge, R. Morris and M. Price

Sussex Psychosocial Oncology Group, Cancer Research UK, Brighton and Sussex Medical School, University of Sussex, Sussex, UK

* Correspondence to: Prof. L. Fallowfield, Sussex Psychosocial Oncology Group, Cancer Research UK, Brighton & Sussex Medical School, University of Sussex, Sussex BN1 9QG, UK. Tel: +44-1273-873015; Fax: +44-1273-873022; E-mail: L.J.Fallowfield{at}sussex.ac.uk

Background: Endocrine therapies for advanced breast cancer include tablets and intramuscular injections. When treatments have similar efficacy and tolerability profiles, addressing preferences about routes of administration is important.

Patients and methods: Two hundred and eight women >2 years post-breast cancer diagnosis were interviewed about their preferences for daily tablets or monthly intramuscular injections. Health-care professionals treating the women estimated patients' preferences.

Results: Sixty-three per cent of patients preferred tablets, 24.5% preferred the injection and 12.5% had no preference. The most cited reasons for tablet preference were convenience and dislike of needles; for injection preference, adherence and convenience. Variables associated with preferences were body mass index, educational level, attitudes towards injections and efficacy perceptions. Estimates about patients' preferences by health-care professionals varied widely. When asked to imagine scenarios where injections produced fewer hot flushes, or where two injections monthly improved efficacy, injection preference increased to 60.6% and 74.5%, respectively. Disturbingly, ~50% of patients admitted they sometimes forgot or chose not to take their current oral medication.

Conclusions: The majority of breast cancer patients preferred hormone therapy via daily tablets rather than monthly injections. Information about side-effects or improved efficacy altered these preferences. Adherence to treatment cannot be assumed; patients' preferences about drug administration may influence this.

Key words: breast cancer, fulvestrant injections, patient preferences, tablet adherence


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