Beliefs About Medication and Uptake of Preventive Therapy in Women at Increased Risk of Breast Cancer: Results From a Multicenter Prospective Study
Beliefs About Medication and Uptake of Preventive Therapy in Women at Increased Risk of Breast Cancer: Results From a Multicenter Prospective Study
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DOI：
10.1016/j.clbc.2018.10.008
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发表时间：
2019-02-01
影响因子：
3.1
通讯作者：
Wiseman, Julia
中科院分区：
文献类型：
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作者：
Thorneloe, Rachael Jane;Horne, Rob;Wiseman, Julia
对于乳腺癌风险较高的女性来说，预防性治疗（例如他莫昔芬）是一种降低风险的选择。人们对影响化学预防决定的心理因素知之甚少。通过潜在特征分析，报告对预防性治疗的需求较低且对药物有强烈担忧的女性不太可能开始他莫昔芬治疗。药物信念是支持明智决策的目标。简介：乳腺癌预防疗法的采用率较低。我们研究了乳腺癌风险增加的女性是否可以分为具有相似药物信念的群体，以及信念群体成员资格是否与预防性治疗的采用前瞻性相关。患者和方法：我们接触了参加讨论乳腺癌风险的预约的女性 (n - 732)； 408 人 (55.7%) 完成了对药物的信念和对药物的敏感性调查问卷。据报告，3 个月时服用他莫昔芬的人数为 258 人 (632%)。使用潜在概况分析来确定信念组的最佳数量。结果：他莫昔芬的摄取率为 14.7% (38/258)。五分之一的女性（19.4%；78/402）报告强烈需要他莫昔芬。模型拟合统计支持 2 组模型。两个群体对于当前和未来的健康需要他莫昔芬的信念都很薄弱。与第 1 组（62%；252/406）相比，第 2 组（38%；样本中的 154/406）对他莫昔芬和一般药物有更强烈的担忧，并且对药物的负面影响有更强的感知敏感性。低必要性和较低担忧的女性（第 1 组）比那些低必要性和较高担忧的女性（第 2 组）（6.4%；5/78）更有可能开始服用他莫昔芬（18.3%；33/180）。调整人口和临床因素后，比值比为 3.37（95% 置信区间，1.08-10.51；P - .036）。结论：乳腺癌预防治疗的采用率较低。一部分女性报告称对预防性治疗的需求较低，并且对药物治疗有强烈的担忧。这些女性不太可能开始服用他莫昔芬。药物信念是支持明智决策的目标。 (C) 2018 作者。由爱思唯尔公司出版
Preventive therapies, such as tamoxifen, are a risk reduction option for women at increased risk of breast cancer. Little is known about the psychological factors influencing the decision to use chemoprevention. Using latent profile analysis, women who reported a low need for preventive therapy and strong medication concerns were less likely to initiate tamoxifen treatment. Medication beliefs are targets for supporting informed decision-making.Introduction: Uptake of preventive therapies for breast cancer is low. We examined whether women at increased risk of breast cancer can be categorized into groups with similar medication beliefs, and whether belief group membership was prospectively associated with uptake of preventive therapy. Patients and Methods: Women (n - 732) attending an appointment to discuss breast cancer risk were approached; 408 (55.7%) completed the Beliefs About Medicines and the Perceived Sensitivity to Medicines questionnaires. Uptake of tamoxifen at 3 months was reported in 258 (632%). The optimal number of belief groups were identified using latent profile analysis. Results: Uptake of tamoxifen was 14.7% (38/258). One in 5 women (19.4%; 78/402) reported a strong need for tamoxifen. The model fit statistics supported a 2-group model. Both groups held weak beliefs about their need for tamoxifen for current and future health. Group 2 (38%; 154/406 of the sample) reported stronger concerns about tamoxifen and medicines in general, and stronger perceived sensitivity to the negative effects of medicines compared with group 1 (62%; 252/ 406). Women with low necessity and lower concerns (group 1) were more likely to initiate tamoxifen (18.3%; 33/180) than those with low necessity and higher concerns (group 2) (6.4%; 5/78). After adjusting for demographic and clinical factors, the odds ratio was 3.37 (95% confidence interval, 1.08-10.51; P - .036). Conclusion: Uptake of breast cancer preventive therapy was low. A subgroup of women reported low need for preventive therapy and strong medication concerns. These women were less likely to initiate tamoxifen. Medication beliefs are targets for supporting informed decision-making. (C) 2018 The Authors. Published by Elsevier Inc.