Cancer Treatment Adherence Among Low-Income Women With Breast or Gynecologic Cancer
Cancer Treatment Adherence Among Low-Income Women With Breast or Gynecologic Cancer
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DOI：
10.1002/cncr.24500
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发表时间：
2009-10-01
期刊：
影响因子：
6.2
通讯作者：
Palinkas, Lawrence A.
中科院分区：
文献类型：
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作者：
Ell, Kathleen;Vourlekis, Betsy;Palinkas, Lawrence A.
背景技术背景：作者实施了一项对照、随机试验，比较了2种干预措施：提供书面资源导航信息（增强常规护理[EUC]）与书面信息加患者导航（TPN），旨在改善487名低收入、主要是西班牙裔乳腺癌或妇科癌症女性的辅助治疗依从性和随访。方法：妇女随机接受TPN或EUC;化疗，放疗，激素治疗和随访超过12个月进行评估。乳腺癌患者与妇科癌症患者分开分析。结果：总体依从率范围为87%-94%，TPN组和EUC组之间无显著差异。在乳腺癌女性中，90%的EUC组和88%的TPN组完成了化疗（14%的EUC组和26%的TPN组延迟了化疗的完成），2%的EUC组和4%的TPN组未能完成化疗，8%的EUC组和7%的TPN组拒绝化疗。两组的放疗依从性相似：90%的患者完成了放疗（EUC组40%和TPN组42%延迟了放疗的完成）;两组中，2%的患者未能完成放疗，8%的患者拒绝放疗。在妇科患者中，87%的EUC组和94%的TPN组完成了化疗（41%的EUC组和31%的TPN组延迟完成化疗），7%的EUC组和6%的TPN组未能完成化疗，6%的EUC组拒绝化疗，EUC组和TPN组分别有87%和84%完成了放疗（51%的EUC组和42%的TPN延迟），5%的EUC组和8%的TPN组未能完成放疗，EUC组和TPN组分别有8%和5%的患者拒绝放疗。结论：随机分组的治疗依从性明显高于先前研究中的报告，这表明主动电话患者导航或书面资源信息材料可能有助于低收入，主要是西班牙裔女性的依从性。联邦州乳腺癌和宫颈癌治疗资金也可能促进了依从性。Cancer 2009;115：4606-15. (C)2009年美国癌症协会。
BACKGROUND: The authors implemented a controlled, randomized trial that compared 2 interventions: the provision of written resource navigation information (enhanced usual care [EUC]) versus written information plus patient navigation (TPN) aimed at improving adjuvant treatment adherence and follow-up among 487 low-income, predominantly Hispanic women with breast cancer or gynecologic cancer. METHODS: Women were randomized to receive either TPN or EUC; and chemotherapy, radiation therapy, hormone therapy, and follow-up were assessed over 12 months. Patients with breast cancer were analyzed separately from patients with gynecologic cancer. RESULTS: Overall adherence rates ranged from 87% to 94%, and there were no significant differences between the TPN group and the EUC group. Among women with breast cancer, 90% of the EUC group and 88% of the TPN group completed chemotherapy (14% of the EUC group and 26% of the TPN group delayed the completion of chemotherapy), 2% of the EUC group and 4% of the TPN group failed to complete chemotherapy, and 8% of the EUC group and 7% of the TPN group refused chemotherapy. Radiation treatment adherence was similar between the groups: Ninety percent of patients completed radiation (40% of the EUC group and 42% of the TPN group delayed the completion of radiation); in both groups, 2% failed to complete radiation, and 8% refused radiation. Among gynecologic patients, 87% of the EUC group and 94% of the TPN group completed chemotherapy (41% of the EUC group and 31% of the TPN group completed it with delays), 7% of the EUC group and 6% of the TPN group failed to complete chemotherapy, 6% of the EUC refused chemotherapy, 87% of the EUC group and 84% of the TPN group completed radiation (51% of the EUC group and 42% of the TPN with delays), 5% of the EUC group and 8% of the TPN group failed to complete radiation, and 8% of the EUC group and 5% of the TPN group refused radiation. CONCLUSIONS: Treatment adherence across randomized groups was notably higher than reported in previous studies, suggesting that active telephone patient navigation or written resource informational materials may facilitate adherence among low-income, predominantly Hispanic women. Adherence also may have be facilitated by federal-state breast and cervical cancer treatment funding. Cancer 2009;115:4606-15. (C) 2009 American Cancer Society.