Cost‐Related Medication Underuse and Coping Behaviors in Breast Cancer Survivors Taking Cardiovascular Risk Reduction Medication Enrolled in the National Institutes of Health All of us Research Program
16 affiliations
- 1Department of Kinesiology and Health Sciences, College of Humanities and Sciences Virginia Commonwealth University Richmond Virginia USA
- 2VCU Massey Comprehensive Cancer Center Richmond Virginia USA
- 3Department of Biostatistics, School of Public Health Virginia Commonwealth University Richmond Virginia USA
- 4Tampa General Hospital Tampa Florida USA
- 5College of Nursing University of South Florida Tampa Florida USA
- 6Division of Nursing Sciences Rutgers University New Brunswick New Jersey USA
- 7Department of Population Health and Health Disparities, School of Public and Population Health The University of Texas Medical Branch Galveston Texas USA
- 8Division of Cardiology, Department of Medicine Medical College of Georgia at Augusta University Augusta Georgia USA
- 9Cardio‐Oncology Program Medical College of Georgia at Augusta University Augusta Georgia USA
- 10Case Western Reserve University School of Medicine Case Western Reserve University Cleveland Ohio USA
- 11Department of Hematology‐Oncology University Hospitals Seidman Cancer Center Cleveland Ohio USA
- 12Department of Cancer Sciences Cleveland Clinic Cleveland Ohio USA
- 13Department of Health Policy Research Virginia Commonwealth University Richmond Virginia USA
- 14Department of Pharmacotherapy and Outcomes Science, School of Pharmacy Virginia Commonwealth University Richmond Virginia USA
- 15College of Pharmacy and Pharmaceutical Sciences Florida A&M University Tallahassee Florida USA
- 16Division of Cardiology Virginia Commonwealth University Health System Richmond Virginia USA
Abstract
Background: Breast cancer survivors are at increased risk of cardiovascular disease throughout survivorship. Recent studies documented suboptimal adherence to cardiovascular risk reduction medications, but studies identifying contributors to this behavior are lacking. The association between sociodemographic characteristics, social drivers of health factors, and cost‐related medication behaviors in survivors who were taking antihyperlipidemics or antihypertensives was evaluated.
Methods: These cross‐sectional analyses utilized data from the National Institutes of Health All of Us Research Program from May 31, 2017 to October 1, 2023. Cohort eligibility included identifying as Black/African American or White, being at least 18 years old, and having a diagnosis of breast cancer. The outcome, cost‐related medication underuse and coping behaviors, was assessed using a seven‐item scale. Bivariable and multivariable logistic regression models were used to evaluate the associations of covariates and the outcome for each of the cardiovascular risk medication classes.
Results: Compared to Black survivors, White survivors had higher odds of asking for lower‐cost medications among antihyperlipidemics users (pooled adjusted OR = 1.69; 95% CI: 1.18–2.40; FDR‐adjusted p = 0.012) and antihypertensives users (pooled adjusted OR = 2.03; 95% CI: 1.50–2.76; FDR‐adjusted p = 0.004). Survivors who reported greater social support were less likely to delay filling their prescription to save money when compared to survivors who reported lower social support.
Conclusions: Some survivors are more likely to engage in cost‐related coping and underuse behaviors than others. Clinicians, including primary care providers, should include discussions and resources about non‐cancer therapy adherence‐related financial challenges with their patients who are cancer survivors.
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BibTeX
@article{sutton2026costrelated,
title = {{Cost‐Related Medication Underuse and Coping Behaviors in Breast Cancer Survivors Taking Cardiovascular Risk Reduction Medication Enrolled in the National Institutes of Health All of us Research Program}},
author = {Arnethea L. Sutton and Jian He and Robert A. Perera and Lakeshia Cousin and Keesha Powell‐Roach and Mandy J. Hill and Avirup Guha and Nickolas Stabellini and Paulette Omeaku and Teresa M. Salgado and Vanessa B. Sheppard and Wendy Bottinor},
journal = {Cancer Medicine},
year = {2026},
month = nov,
doi = {10.1002/cam4.72462},
url = {https://doi.org/10.1002/cam4.72462},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Cost‐Related Medication Underuse and Coping Behaviors in Breast Cancer Survivors Taking Cardiovascular Risk Reduction Medication Enrolled in the National Institutes of Health All of us Research Program
AU - Arnethea L. Sutton
AU - Jian He
AU - Robert A. Perera
AU - Lakeshia Cousin
AU - Keesha Powell‐Roach
AU - Mandy J. Hill
AU - Avirup Guha
AU - Nickolas Stabellini
AU - Paulette Omeaku
AU - Teresa M. Salgado
AU - Vanessa B. Sheppard
AU - Wendy Bottinor
PY - 2026
DA - 2026/11/05
JO - Cancer Medicine
DO - 10.1002/cam4.72462
UR - https://doi.org/10.1002/cam4.72462
AB - Background: Breast cancer survivors are at increased risk of cardiovascular disease throughout survivorship. Recent studies documented suboptimal adherence to cardiovascular risk reduction medications, but studies identifying contributors to this behavior are lacking. The association between sociodemographic characteristics, social drivers of health factors, and cost‐related medication behaviors in survivors who were taking antihyperlipidemics or antihypertensives was evaluated. Methods: These cross‐sectional analyses utilized data from the National Institutes of Health All of Us Research Program from May 31, 2017 to October 1, 2023. Cohort eligibility included identifying as Black/African American or White, being at least 18 years old, and having a diagnosis of breast cancer. The outcome, cost‐related medication underuse and coping behaviors, was assessed using a seven‐item scale. Bivariable and multivariable logistic regression models were used to evaluate the associations of covariates and the outcome for each of the cardiovascular risk medication classes. Results: Compared to Black survivors, White survivors had higher odds of asking for lower‐cost medications among antihyperlipidemics users (pooled adjusted OR = 1.69; 95% CI: 1.18–2.40; FDR‐adjusted p = 0.012) and antihypertensives users (pooled adjusted OR = 2.03; 95% CI: 1.50–2.76; FDR‐adjusted p = 0.004). Survivors who reported greater social support were less likely to delay filling their prescription to save money when compared to survivors who reported lower social support. Conclusions: Some survivors are more likely to engage in cost‐related coping and underuse behaviors than others. Clinicians, including primary care providers, should include discussions and resources about non‐cancer therapy adherence‐related financial challenges with their patients who are cancer survivors.
SN - 2045-7634
ER -