Depression as a predictor of adherence to adjuvant endocrine therapy (AET) in women with breast cancer: a systematic review and meta-analysis - PubMed (original) (raw)

Meta-Analysis

Depression as a predictor of adherence to adjuvant endocrine therapy (AET) in women with breast cancer: a systematic review and meta-analysis

Brent T Mausbach et al. Breast Cancer Res Treat. 2015 Jul.

Abstract

The purpose of this meta-analysis was to analyze the available evidence concerning the effects of depression on non-adherence to adjuvant endocrine therapy (AET) in women with breast cancer. MEDLINE and PsycInfo databases from inception through May 1, 2015 were searched using terms related to AET adherence. Articles were reviewed and selected based on predetermined selection criteria, and effect sizes from included studies were extracted. Pooled effect estimates were obtained using random-effects meta-analyses. Of the 312 articles identified, 9 met the inclusion criteria. Overall, depression was significantly associated with non-adherence to AET (Cohen's d = 0.35, 95% CI 0.19-0.52). This effect was not significantly moderated by patient age (<65 vs ≥65 years), length of study follow-up (<18 months vs ≥18 months), or method of assessing adherence (objective vs self-report). However, within these subgroups, significant effects of depression were found only for younger patients (d = 0.46; 95% CI 0.19-0.72) and in studies of shorter duration (<18 months) (d = 0.49; 95% CI 0.22-0.76). These results suggest that AET adherence may be lower among women with greater depressive symptoms, and this effect may be exacerbated in younger women during the early phases (<18 months) of AET. Management of depressive symptoms in women with breast cancer may help in enhancing adherence to AET and improve cancer treatment outcomes.

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Conflict of interest statement

Conflict of interest The authors declare that they have no conflict of interest.

Figures

Fig. 1

Search and study selection process

Fig. 2

Forest plot of the effect size for the relations between depression and adherence to adjuvant endocrine therapy

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Depression as a predictor of adherence to adjuvant endocrine therapy (AET) in women with breast cancer: a systematic review and meta-analysis - PubMed (original) (raw)