Adherence to adjuvant hormonal therapy among breast cancer survivors in clinical practice: a systematic review.
Adherence to adjuvant hormonal therapy among breast cancer survivors in clinical practice: a systematic review.
复制标题
DOI：
10.1007/s10549-012-2114-5
复制
发表时间：
2012-07
影响因子：
3.8
通讯作者：
Vernon, Sally W.
中科院分区：
文献类型：
--
作者：
Murphy, Caitlin C.;Bartholomew, L. Kay;Carpentier, Melissa Y.;Bluethmann, Shirley M.;Vernon, Sally W.
辅助性激素治疗显著提高激素受体阳性乳腺癌患者的长期生存率尽管他莫昔芬和芳香化酶抑制剂的临床疗效已得到证实，但许多乳腺癌幸存者要么未能按规定的频率服用正确的剂量（坚持），要么停止治疗（持续）。本系统性综述旨在：1）确定临床实践中乳腺癌幸存者对辅助激素治疗的依从性和持续性的患病率，2）确定依从性和持续性的相关性。我们在Medline、PubMed、PsycINFO和CINAHL中检索了测量辅助激素治疗依从性和/或持续性的比率和/或相关性的研究。在多步骤过程中审查研究：1）主要作者筛选所有潜在合格研究的标题和摘要; 2）每位合著者审查随机5%的摘要样本; 3）两组合著者各自审查所有“可能”摘要的一半。任何分歧都要讨论，直到达成共识。29项研究符合纳入标准。依从性的患病率范围为41-72%，中止（即，非持久性）范围为31- 73%，在5年治疗结束时测量。极端年龄（年龄较大或较年轻）、自付费用增加、全科医生（与肿瘤学家相比）的随访护理、较高的CYP 2D 6活性、从一种治疗形式转换为另一种治疗形式以及治疗副作用与依从性和/或持久性呈负相关。在基线时服用更多的药物，转诊给肿瘤学家，以及诊断时的早期与依从性和/或持久性呈正相关。乳腺癌幸存者中辅助激素治疗的依从性和持久性是次优的。迄今为止研究的许多关于坚持和持久性的相关性是不可改变的。我们的综述显示，迫切需要进一步研究与辅助激素治疗依从性相关的可改变因素，并制定行为干预措施以提高这一人群的依从性。
Adjuvant hormonal therapy significantly improves long-term survival of breast cancer patients with hormone receptor-positive disease. Despite the proven clinical efficacy of tamoxifen and aromatase inhibitors, many breast cancer survivors either fail to take the correct dosage at the prescribed frequency (adherence) or discontinue therapy (persistence). This systematic review aims to: 1) determine the prevalence of adherence and persistence to adjuvant hormonal therapy among breast cancer survivors in clinical practice, and 2) identify correlates of adherence and persistence. We searched Medline, PubMed, PsycINFO, and CINAHL for studies that measured rates and/or correlates of adherence and/or persistence to adjuvant hormonal therapy. Studies were reviewed in a multi-step process: 1) the lead author screened titles and abstracts of all potentially eligible studies; 2) each coauthor reviewed a random 5% sample of abstracts; and 3) two sets of coauthors each reviewed half of all “maybe” abstracts. Any disagreements were discussed until consensus was reached. Twenty nine studies met inclusion criteria. Prevalence of adherence ranged from 41–72% and discontinuation (i.e., nonpersistence) ranged from 31–73%, measured at the end of 5 years of treatment. Extremes of age (older or younger), increasing out-of-pocket costs, follow-up care with a general practitioner (vs. oncologist), higher CYP2D6 activity, switching from one form of therapy to another, and treatment side effects were negatively associated with adherence and/or persistence. Taking more medications at baseline, referral to an oncologist, and earlier year at diagnosis were positively associated with adherence and/or persistence. Adherence and persistence to adjuvant hormonal therapy among breast cancer survivors is suboptimal. Many of the correlates of adherence and persistence studied to date are not modifiable. Our review reveals a critical need for further research on modifiable factors associated with adherence to adjuvant hormonal therapy, and the development of behavioral interventions to improve adherence in this population.
登录
查看更多内容
影响因子：
2.1
作者：
Albert, Ute-Susann;Zemlin, Cosima;Kalder, Matthias
通讯作者：
Kalder, Matthias
影响因子：
2.8
作者：
Gallicchio, L.;MacDonald, R.;Helzlsouer, K. J.
通讯作者：
Helzlsouer, K. J.
影响因子：
168.9
作者：
Davies, C.;Godwin, J.;Gray, R.;Clarke, M.;Darby, S.;McGale, P.;Wang, Y. C.;Peto, R.;Pan, H. C.;Cutter, D.;Taylor, C.;Ingle, J.
通讯作者：
Ingle, J.
影响因子：
3
作者：
Garreau, Jennifer R.;DeLaMelena, Tammy;Johnson, Nathalie
通讯作者：
Johnson, Nathalie
影响因子：
45.3
作者：
Demissie, S;Silliman, RA;Lash, TL
通讯作者：
Lash, TL