Non-adherence to the Use of Tamoxifen in the First year by the Breast Cancer Patients in an African Population

Background: Tamoxifen has been in use worldwide in the care of breast cancer over decades. It has been found to significantly reduce disease free survival and also reduce the chance of recurrence. The issue of non-adherence (NA) to its usage has not been reported in the black African setting. The aim of this study was to determine the rate and contributory factors to non adherence rate to tamoxifen during the first year of usage in patients with breast cancer in LAUTECH teaching hospital (LTH) Osogbo , Nigeria .
Methods: One hundred and fourteen patients (108 females and 6 males) were studied during their various first year of tamoxifen usage at LTH Osogbo, South-Western Nigeria between June 2001 and June 2005.The incidence, indications and variables that might contribute to NA e.g. age, sex, disease stage, occupation etc were assessed.
Results: Findings included NA rate of 24.5 % (72% of which occurred in the first 6 months of usage). Adherence tend to be worse in younger patients and those with advance disease stage (p=0.154 and 0.146 respectively). Non-adherence was commoner in farmers and traders while unbearable side effects and financial constraints were most common reasons.
Conclusion: The 24.5% non-adherence rate, though comparable with results from other reports is unacceptably high.These patients could not have been receiving full benefits of hormonal treatment, thus adequate counseling and education on benefit and side effects of tamoxifen is strongly advised.