Patients’ Experience of Medication Brand Changes during Hormone Therapy for Breast Cancer—An Interpretative Phenomenological Analysis
2. Materials and Methods
2.2. Participants and Procedures
3.1. Experiencing Brand Changes
3.1.1. Feeling the Change in Brands—Impact on Wellbeing
‘Well, I had side effects with tamoxifen right from the beginning and it was worse as I changed to generics. And it was complete lethargy, absolute complete lethargy’ (Mary).
‘Oh yes, [smiling] yes, yes. I discovered the different brands give you quite different reactions’ (Diane).
‘No, not that I have noticed. I think…well, you see it has not really been long enough because I started in January. And the new packet only came about a month ago. So maybe I’ve only had 4–5 months with one packet and another month with another. So maybe haven’t had long enough to notice’ (Rose).
‘For me, I wasn’t aware of any difference in the brands. May have been or it may not, I couldn’t say, but for me just the antiestrogen effect is so awful that I am not sure that the brands differences would make much of a difference if you know what I mean?’ (Sue)
‘That month was horrible, with the tamoxifen, I had a particular month but with much worse [side effects] than the one before, and then it was fine again and I felt Uhhh… so let’s see then so, you know, I did a little experiment and I did keep a note and kept my boxes so I knew which ones I got, that’s what my body made me decide that I just didn’t want that particular brand’ (Helen).
‘So, the first change [pause] I think I did notice it, but it wasn’t too extreme, but it was when… it was this one where it was very extreme, it’s TG*’ (Kate).
‘I’m happy with RG* think it is, that’s fine. I think it’s WG* gives me really bad knee pain, so I avoid WG*’ (Liz).
‘I just had so many more side effects [new generic] and also swapping…. swapping brands has an effect on me emotionally… sort of how you feel, and I mean, so I was just expecting the WG* one, and these are the side effects and you get used to it, then again a new brand […].
Because… just because when they change brands, I mean there’s the side effects, it does affect your mood anyways, but for me it’s like for two weeks…the world seems very… sounds stupid, very bleak and everything just seems very hard and difficult to cope with. And since they stopped the brand on me, other than the other side effects, that’s what you are coping with and on top of… I mean I’m slightly further away from breast cancer now, but when you first get it…you know, I was going through radiotherapy and you’ve just had surgery, and it’s like… you look at things and you think ‘oh I am fine now’. It takes several months to have come to terms with things and get your head around it and to sort of have the change, you know the impact of the changing pills on top of that is actually quite a lot. And people, I guess me, before you have cancer you don’t realise the mental impacts, the long-term impacts. You know, you just think about: ‘Oh you have this operation, you have this treatment, and then fine.’ But.. well, then you know it’s really not like that’ (Anna).
3.1.2. Losing and Regaining Control over Treatment
‘It was just what I was given at the pharmacy. It wasn’t like … nobody said you will be taking a different brand, or you know, but it was just what I was given’ (Kate).
‘Well, as I said, I was under the assumption, I mean I can’t remember having that conversation, they [GPs] were told they have to give generics because they were cheaper. In a way I didn’t have an option unless I started paying for it’ (Mary).
‘It actually happened by accident. So, I don’t know if you’re aware that the pharmacists, if you say tamoxifen, they just give you whatever brand they have in stock. So I started off with WG* tamoxifen which is almost quite lucky because it is a brand I had the fewest side effects from. And then the next month, just because it said just tamoxifen again, they gave me TG*. It just had so many more side effects’ (Anna).
‘I went round, and this is typical of a number of my friends, we’ve all gone round various pharmacies saying: what brands do you have, what can you get, and some chemists say, ‘we get whatever the suppliers send us, we can’t ask for something’. So there is a lot of trial and error until I found somebody [a pharmacist] that was sympathetic’ (Diane).
‘So actually, I contacted the manufacturer to check what they [pharmacy] were telling me. So coming from the pharmaceutical industry sort of help things, so they told me that it has stopped manufacturing 20 mg, that it was not available and what was available. So that I actually said to [name of pharmacy]: ‘But the 10 mg. is available’. They said, ‘go back to the GP to get your prescription change so you get it’. So, I was very focused on what I wanted, basically [laughing]’ (Anna).
3.1.3. A Motivation to Continue with Treatment
‘Yes, I think it is very important, you know, and I do feel if someone feels that the proper branded drug is good for you, they should be allowed and not force you into generics’ (Mary).
‘Oh yes, Oh yeah, I thought if I continue having to take WG* I’m gonna have a real problem about continuing, but finally I found one [brand] that is not too bad’ (Diane).
‘I think it’s important because if you find the right one then I think you can stay on it for longer’ (Liz).
‘Well, I know one that was awful, but I’m afraid…I actually saved this [package] cause I refused to take the final one. The side effects were so horrendous with this one and…it’s TG* I’m not taking it’ (Kate).
3.2. Responsiveness of Health Care Providers
3.2.1. Feeling Abandoned by the Health System—Context of Lack of Continuity of Care
‘I’m on this, sounds really weird, it sounds really weird to me, but I’m on a five-year survival plan with the breast care unit. And I meant to have like open access to them, but the two times I have tried to get in touch with a breast care nurse, I have not heard anything back. And I just think they’re so busy’ (Kate).
‘I felt also that you know once my treatment was over, that was it, and everybody I’ve spoken to had the same feeling that suddenly it all stops and you’re left on your own to cope, and psychologically… I am quite a resilient person but that was very, very difficult’ (Diane).
‘I haven’t had a great experience with them in the four years I’ve been under them, so I wasn’t overly keen to keep going. All it did was stress me out going to appointments where nothing really happened and it was only the last one where I said no, I want to do the talking at this one. […] the only time I mentioned that I didn’t like the side effects it was just in passing [...] and I said oh you know the side effects of tamoxifen and then he just said ‘Oh well they’re all, they’re all much the same’ (Helen).
3.2.2. Encountering Disbelief
‘Well, I started off with my GP and the GP said we don’t request particular brands because we don’t want to be associated with a particular pharmaceutical company, and I understood that, but then, then they said, I spoke to two different GPs, they said is the same formulation so you shouldn’t have any difference’ (Diane).
‘I think if there would be more understanding, awareness that different brands does make a difference. Because I did feel like the pharmacist didn’t really believe me’ (Anna).
‘I think you’ll find most doctors, I am not sure about nurses, but most doctors will say there is no difference in brands, I mean actual brands, names, but most doctors would say there is no difference’ (Sue).
‘I was actually shocked how different the side effects are between different brands because you know if people said it to me before I was sceptical’ (Anna).
‘Actually, I think, and I don’t know why this happens to a lot of people but I have thought about it myself that, you know… the pharmacy a little bit like […] they are the gate keeper to your drugs, and to be honest at one point when I went for very early on you know, you just think: aren’t we going through… haven’t we been through enough to not just give us the thing? We don’t even want to take the… you know, who wants to take letrozole? But it’s a must, but surely you can give us the one we want’ (Julie).
3.2.3. Feeling Lucky
‘When I got really, really bad knee pain, like for a long time, I rang my doctor and I said could it be the tamoxifen? And like if it is, can we change the brand? And he got the delivered straight away. [...] I don’t know if he agreed necessarily, but he definitely went along with it’ (Liz).
‘I ended up with a pharmacist, that you know, as I said, after quite a lot of trial and error, a pharmacist who is very sympathetic’ (Diane).
‘I’ve got one friend in the group that I mentioned to you, who just stopped it altogether because she couldn’t find a brand that was supportive to her, so she stopped. But again, she was like me, she couldn’t get a discussion going about what the differences might be’ (Diane).
3.3. Future Expectations
3.3.1. Needing Information about Brands
‘Well, possibly cause it all comes through my GP now… And… My GP has been great. So, I think that I needed to be told that I could… It’s kind of like… I should be able to say: ‘No, this brand is really, I’m really not dealing with it well. I don’t want it again. Can I have…?’ There’s just been no dialogue about it, so it’s… I think yeah, because you know my prescription is issued by my GP… I should know that I can talk to them’ (Kate).
‘I think it would be helpful at a stage of breast care nurse, oncologist, something like that to mention to you…this might happen because nobody said it to me emm…or gave any options and you know, like if you don’t get on with this one [brand] there’s that one, or told me like to watch out for anything. Nobody said that. And I think that would have been helpful because sometimes you just panic, you know, like you think you’ve got like new symptoms and stuff. Whereas actually if you know that there might be other options, it would be better’ (Liz).
‘So when I mentioned a side effect to the oncologist at my six-monthly review, he said: “Always stick to the same brand”, then AR*brand name. Between my GP and the pharmacy…emm they told me that it’s something to do with costs and…emm availability. So, to be honest, I just started taking what they gave me […]. I would say: “Can I have the AR* brand name please?” and they would say: “Well, we’re not allowed to do that”. And to be honest, I’ve been backwards and forwards so much about trying to check that I just gave up’ (Julie).
3.3.2. Seeking Specialists’ Reassurances
‘But it is to just actually have the support and I think that they [oncologists] weren’t interested or bothered. But to expect you to stay on it [medication] but giving you no support’ (Anna).
‘Believe me, you just don’t want to have to go and row with the pharmacy and they don’t want to row with you, their life is miserable as well at the moment. It’s the feeling that you don’t have anyone to talk to, I think that’s the issue. And at the moment people can’t make an appointment anyway, they say “there is none to talk to”. So at the moment people will just be making their own decisions based on anything and nothing which is really worrying’ (Helen).
‘I mean my main interest in the therapy is whether or not it’s worth the risk of increased side effects, so I don’t think there is enough information from many healthcare professionals on either the different types you can take or that risk benefit analysis of… really working out whether or not you should take it in the first place’ (Rose).
‘I think treatment should be a little more individualised. But I can understand, you know, I worked in hospitals all my life so I can understand from the other point of view, you’ve got the guidelines, the guidelines is there and you know therefore you’ve to encourage women to follow the guidelines, so it’s a tricky one, is quite tricky, but the women need to know how much the increase survival is to decide if it’s worth it’ (Sue).
3.3.3. Role of the Pharmacist in Managing Brand Changes
‘The pharmacy is probably a good place actually cause they do understand what you are talking about‘ (Diane).
‘So yeah, pharmacist is probably your best person, is medication related, it is what pharmacists are supposed to be doing, discussing it’ (Helen).
‘I personally wouldn’t recommend having a specific brand prescribed cause it makes life really difficult for everybody. But I would say that anyone who is having difficulties should be advised to keep a diary and see if there is anything that they can pinpoint and it may not be the brand […] but it might be that month it was particularly hot, like it is now, or it might have been you were particularly stressed -work, kids, whatever. […] And if you can find which brand you don’t get on with, that still leaves you quite a few to have rather than just saying I can only have this one, which limits what you can have’ (Helen).
‘I think the pharmacist because I don’t always want to bother the doctor, the GP with things like this or sometimes you know you can ring up and not get an appointment for two weeks, whereas if you could go to the pharmacist and say, ‘can you make sure when tamoxifen comes in, I get this brand?’ And it can be managed at that level. I think it would make it a lot easier’ (Liz).
‘I guess, I guess what would make it easier is if there was more of a connect between the pharmacy and the GP and the oncologist, which there doesn’t really seem to be’ (Julie).
Strengths and Limitations
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
- Cancer Research UK. Breast Cancer Statistics. 2021. Available online: https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/breast-cancer#heading-Zero (accessed on 15 August 2022).
- Huiart, L.; Bouhnik, A.D.; Rey, D.; Rousseau, F.; Retornaz, F.; Meresse, M.; Bendiane, M.K.; Viens, P.; Giorgi, R. Complementary or alternative medicine as possible determinant of decreased persistence to aromatase inhibitor therapy among older women with non-metastatic breast cancer. PLoS ONE 2013, 8, e81677. [Google Scholar] [CrossRef][Green Version]
- Hershman, D.L.; Kushi, L.H.; Shao, T.; Buono, D.; Kershenbaum, A.; Tsai, W.Y.; Fehrenbacher, L.; Gomez, S.L.; Miles, S.; Neugut, A.I. Early discontinuation and nonadherence to adjuvant hormonal therapy in a cohort of 8769 early-stage breast cancer patients. J. Clin. Oncol. 2010, 28, 4120–4128. [Google Scholar] [CrossRef] [PubMed]
- Partridge, A.H.; Wang, P.S.; Winer, E.P.; Avorn, J. Nonadherence to adjuvant tamoxifen therapy in women with primary breast cancer. J. Clin. Oncol. 2003, 21, 602–606. [Google Scholar] [CrossRef] [PubMed]
- Horne, R.; Weinman, J. Patients’ beliefs about prescribed medicines and their role in adherence to treatment in chronic physical illness. J. Psychosom. Res. 1999, 47, 555–567. [Google Scholar] [CrossRef]
- Moon, Z.; Moss-Morris, R.; Hunter, M.S.; Carlisle, S.; Hughes, L.D. Barriers and facilitators of adjuvant hormone therapy adherence and persistence in women with breast cancer: A systematic review. Patient Prefer. Adherence 2017, 11, 305–322. [Google Scholar] [CrossRef][Green Version]
- Toivonen, K.I.; Williamson, T.M.; Carlson, L.E.; Walker, L.M.; Campbell, T.S. Potentially Modifiable Factors Associated with Adherence to Adjuvant Endocrine Therapy among Breast Cancer Survivors: A Systematic Review. Cancers 2020, 13, 107. [Google Scholar] [CrossRef] [PubMed]
- Eraso, Y.; Stefler, D.; Moon, Z.; Rossi, L.; Assefa, S. Extending Adjuvant Endocrine Therapy for 10 Years: A Mixed-Methods Analysis of Women’s Decision Making in an Online Breast Cancer Forum. Healthcare 2021, 9, 688. [Google Scholar] [CrossRef]
- National Institute for Health and Care Excellence (NICE). British National Formulary. Guidance on Prescribing. 2022. Available online: https://bnf.nice.org.uk/medicines-guidance/guidance-on-prescribing/ (accessed on 27 May 2022).
- NICE. British National Formulary. 2022. Available online: https://www.nice.org.uk/ (accessed on 1 August 2022).
- Kesselheim, A.S.; Misono, A.S.; Shrank, W.H.; Greene, J.A.; Doherty, M.; Avorn, J.; Choudhry, N.K. Variations in pill appearance of antiepileptic drugs and the risk of nonadherence. JAMA Intern. Med. 2013, 173, 202–208. [Google Scholar] [CrossRef][Green Version]
- Dunne, S.S. What Do Users of Generic Medicines Think of Them? A Systematic Review of Consumers’ and Patients’ Perceptions of, and Experiences with, Generic Medicines. Patient 2016, 9, 499–510. [Google Scholar] [CrossRef]
- Straka, R.J.; Keohane, D.J.; Liu, L.Z. Potential Clinical and Economic Impact of Switching Branded Medications to Generics. Am. J. Ther. 2017, 24, e278–e289. [Google Scholar] [CrossRef]
- MacKrill, K.; Petrie, K.J. What is associated with increased side effects and lower perceived efficacy following switching to a generic medicine? A New Zealand cross-sectional patient survey. BMJ Open 2018, 8, e023667. [Google Scholar] [CrossRef] [PubMed][Green Version]
- Rathe, J.; Andersen, M.; Jarbøl, D.E.; Christensen, R.D.; Hallas, J.; Søndergaard, J. Generic Switching and Non-Persistence among Medicine Users: A Combined Population-Based Questionnaire and Register Study. PLoS ONE 2015, 10, e0119688. [Google Scholar] [CrossRef]
- Ström, O.; Landfeldt, E. The association between automatic generic substitution and treatment persistence with oral bisphosphonates. Osteoporos. Int. 2012, 23, 2201–2209. [Google Scholar] [CrossRef] [PubMed]
- Shrank, W.H.; Cadarette, S.M.; Cox, E.; Fischer, M.A.; Mehta, J.; Brookhart, A.M.; Avorn, J.; Choudhry, N.K. Is there a relationship between patient beliefs or communication about generic drugs and medication utilization? Med. Care 2009, 47, 319–325. [Google Scholar] [CrossRef][Green Version]
- Ma, S.; Shepard, D.S.; Ritter, G.A.; Martell, R.E.; Thomas, C.P. The impact of the introduction of generic aromatase inhibitors on adherence to hormonal therapy over the full course of 5-year treatment for breast cancer. Cancer 2020, 126, 3417–3425. [Google Scholar] [CrossRef]
- Winn, A.N.; Fergestrom, N.M.; Neuner, J.M. Using Group-based Trajectory Models and Propensity Score Weighting to Detect Heterogeneous Treatment Effects: The Case Study of Generic Hormonal Therapy for Women With Breast Cancer. Med. Care 2019, 57, 85–93. [Google Scholar] [CrossRef] [PubMed]
- Neuner, J.M.; Kamaraju, S.; Charlson, J.A.; Wozniak, E.M.; Smith, E.C.; Biggers, A.; Smallwood, A.J.; Laud, P.W.; Pezzin, L.E. The introduction of generic aromatase inhibitors and treatment adherence among Medicare D enrollees. JNCI J. Natl. Cancer Inst. 2015, 107, djv130. [Google Scholar] [CrossRef]
- Hershman, D.L.; Tsui, J.; Meyer, J.; Glied, S.; Hillyer, G.C.; Wright, J.D.; Neugut, A.I. The change from brand-name to generic aromatase inhibitors and hormone therapy adherence for early-stage breast cancer. JNCI J. Natl. Cancer Inst. 2014, 106, dju319. [Google Scholar] [CrossRef]
- Qin, X.; Huckfeldt, P.; Abraham, J.; Yee, D.; Virnig, B.A. Generic entry of aromatase inhibitors and pharmaceutical access: Initiation of hormonal therapy, timeliness of initiation, and drug choice. Res. Soc. Adm. Pharm. 2021, 17, 1588–1595. [Google Scholar] [CrossRef]
- Zeidan, B.; Anderson, K.; Peiris, L.; Rainsbury, D.; Laws, S. The impact of tamoxifen brand switch on side effects and patient compliance in hormone receptor positive breast cancer patients. Breast 2016, 29, 62–67. [Google Scholar] [CrossRef]
- Blencowe, N.S.; Reichl, C.; Gahir, J.; Paterson, I. The use of Nolvadex in the treatment of generic Tamoxifen-associated small joint arthralgia. Breast 2010, 19, 243–245. [Google Scholar] [CrossRef] [PubMed]
- Smith, J.; Flowers, P.; Larkin, M. Interpretative Phenomenological Analysis: Theory, Method and Research; Sage: London, UK, 2009. [Google Scholar]
- Yardley, L.; Morrison, L.; Bradbury, K.; Muller, I. The person-based approach to intervention development: Application to digital health-related behavior change interventions. J. Med. Internet Res. 2015, 17, e30. [Google Scholar] [CrossRef] [PubMed]
- Tong, A.; Sainsbury, P.; Craig, J. Consolidated criteria for reporting qualitative research (COREQ): A 32-item checklist for interviews and focus groups. Int. J. Qual. Health Care 2007, 19, 349–357. [Google Scholar] [CrossRef][Green Version]
- Breast Cancer Now. Breast Cancer Now Forum. 2021. Available online: https://forum.breastcancernow.org/ (accessed on 15 March 2022).
- Muggleton, J.; Guy, H.; Howard, R. Breaking the taboo: An interpretative phenomenological analysis of healthcare professionals’ experience of caring for palliative patients with disgusting symptoms. BMJ Support. Palliat. Care 2015, 5, 189–195. [Google Scholar] [CrossRef] [PubMed]
- Spiers, J.; Smith, J.A.; Poliquin, E.; Anderson, J.; Horne, R. The experience of antiretroviral treatment for Black West African women who are HIV positive and living in London: An interpretative phenomenological analysis. AIDS Behav. 2016, 20, 2151–2163. [Google Scholar] [CrossRef][Green Version]
- Piekarz, H.; Langran, C.; Donyai, P. A phenomenological analysis of the experience of taking medication to prevent a further heart attack. Sci. Rep. 2021, 11, 23468. [Google Scholar] [CrossRef]
- Nizza, I.E.; Farr, J.; Smith, J.A. Achieving excellence in interpretative phenomenological analysis (IPA): Four markers of high quality. Qual. Res. Psychol. 2021, 18, 369–386. [Google Scholar] [CrossRef]
- Montague, J.; Phillips, E.; Holland, F.; Archer, S. Expanding Hermeneutic Horizons: Working as Multiple Researchers and with Multiple Participants. Res. Methods Med. Health Sci. 2020, 1, 25–30. [Google Scholar] [CrossRef]
- Brett, J.; Boulton, M.; Fenlon, D.; Hulbert-Williams, N.J.; Walter, F.M.; Donnelly, P.; Lavery, B.A.; Morgan, A.; Morris, C.; Watson, E.K. Adjuvant endocrine therapy after breast cancer: A qualitative study of factors associated with adherence. Patient Prefer. Adherence 2018, 12, 291–300. [Google Scholar] [CrossRef][Green Version]
- Moon, Z.E.; Moss-Morris, R.; Hunter, M.S.; Hughes, L.D. Understanding tamoxifen adherence in women with breast cancer: A qualitative study. Br. J. Health Psychol. 2017, 22, 978–997. [Google Scholar] [CrossRef]
- Clancy, C.; Lynch, J.; Oconnor, P.; Dowling, M. Breast cancer patients’ experiences of adherence and persistence to oral endocrine therapy: A qualitative evidence synthesis. Eur. J. Oncol. Nurs. 2020, 44, 101706. [Google Scholar] [CrossRef]
- Peddie, N.; Agnew, S.; Crawford, M.; Dixon, D.; MacPherson, I.; Fleming, L. The impact of medication side effects on adherence and persistence to hormone therapy in breast cancer survivors: A qualitative systematic review and thematic synthesis. Breast 2021, 58, 147–159. [Google Scholar] [CrossRef] [PubMed]
- Engelhardt, E.G.; Pieterse, A.H.; van der Hout, A.; de Haes, H.J.; Kroep, J.R.; van Ufford-Mannesse, P.Q.; Portielje, J.E.; Smets, E.M.; Stiggelbout, A.M. Use of implicit persuasion in decision making about adjuvant cancer treatment: A potential barrier to shared decision making. Eur. J. Cancer 2016, 66, 55–66. [Google Scholar] [CrossRef]
- Eraso, Y. Oncologists’ perspectives on adherence/non-adherence to adjuvant endocrine therapy and management strategies in women with breast cancer. Patient Prefer. Adherence 2019, 13, 1311–1323. [Google Scholar] [CrossRef][Green Version]
- NICE. Medicines Optimisation: Quality Standard. 2016. Available online: www.nice.org.uk/guidance/qs120 (accessed on 15 June 2022).
- Risser, J.; Jacobson, T.A.; Kripalani, S. Development and psychometric evaluation of the Self-efficacy for Appropriate Medication Use Scale (SEAMS) in low-literacy patients with chronic disease. J. Nurs. Meas. 2007, 15, 203–219. [Google Scholar] [CrossRef]
- Kimmick, G.; Edmond, S.N.; Bosworth, H.B.; Peppercorn, J.; Marcom, P.K.; Blackwell, K.; Keefe, F.J.; Shelby, R.A. Medication taking behaviors among breast cancer patients on adjuvant endocrine therapy. Breast 2015, 24, 630–636. [Google Scholar] [CrossRef] [PubMed][Green Version]
- Shelby, R.A.; Edmond, S.N.; Wren, A.A.; Keefe, F.J.; Peppercorn, J.M.; Marcom, P.K.; Blackwell, K.L.; Kimmick, G.G. Self-efficacy for coping with symptoms moderates the relationship between physical symptoms and well-being in breast cancer survivors taking adjuvant endocrine therapy. Support. Care Cancer 2014, 22, 2851–2859. [Google Scholar] [CrossRef] [PubMed]
- NICE. Medicines Adherence: Involving Patients in Decisions about Prescribed Medicines and Supporting Adherence. 2009. Available online: https://www.nice.org.uk/Guidance/CG76 (accessed on 15 June 2022).
- NHS. Structured Medication Reviews and Medicines Optimisation: Guidance. 2020. Available online: https://www.england.nhs.uk/publication/structured-medication-reviews-and-medicines-optimisation/ (accessed on 12 June 2022).
|Participant (Pseudonym)||Age||Ethnicity||Cancer Stage||Time on HT||Years Prescribed HT||Current HT Status|
|Anna||52||White British||3||1 yr., 3 mo.||5—maybe 10||continues|
|Helen||50||White British||3||5 yrs.||5—maybe 10||undecided|
|Rose||53||White British||?||6 mo.||5||continues|
|Liz||35||White British||1||3 yrs.||10||continues|
|Julie||58||White British||2||3 yrs.||10||continues|
|Mary||71||White British||?||5 yrs.||5||completed|
|Sue||67||White British||2||1 yr., 3 mo.||5||discontinued|
|Diane||71||White British||2||2 yrs.||5||continues|
|Kate||56||White British||2||3 yrs., 5 mo.||indefinitely||continues|
|Superordinate Themes||Subordinate Themes|
|Experiencing brand changes||Feeling the change—impact on wellbeing|
Losing and gaining control over treatment
A motivation to continue with treatment
|Responsiveness of health care providers||Feeling abandoned by the health system—context of lack of continuity of care|
|Future expectations||Needing information about brands |
Seeking specialists’ reassurances
Role of the pharmacists in managing brand changes
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations.
© 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Eraso, Y.; Moon, Z.; Steinberga, I. Patients’ Experience of Medication Brand Changes during Hormone Therapy for Breast Cancer—An Interpretative Phenomenological Analysis. Healthcare 2022, 10, 2558. https://doi.org/10.3390/healthcare10122558
Eraso Y, Moon Z, Steinberga I. Patients’ Experience of Medication Brand Changes during Hormone Therapy for Breast Cancer—An Interpretative Phenomenological Analysis. Healthcare. 2022; 10(12):2558. https://doi.org/10.3390/healthcare10122558Chicago/Turabian Style
Eraso, Yolanda, Zoe Moon, and Ieva Steinberga. 2022. "Patients’ Experience of Medication Brand Changes during Hormone Therapy for Breast Cancer—An Interpretative Phenomenological Analysis" Healthcare 10, no. 12: 2558. https://doi.org/10.3390/healthcare10122558