Adherence to initial adjuvant anastrozole therapy among women with early-stage breast cancer
Adherence to initial adjuvant anastrozole therapy among women with early-stage breast cancer
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DOI：
10.1200/jco.2007.11.5451
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发表时间：
2008-02-01
影响因子：
45.3
通讯作者：
Asnis-Alibozek, Aviva
中科院分区：
文献类型：
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作者：
Partridge, Ann H.;LaFountain, Andrea;Asnis-Alibozek, Aviva
研究目的以前的研究评估了早期乳腺癌妇女对他莫昔芬治疗的依从性，结果显示依从性估计值在25%到96%之间。没有以前的研究集中在坚持辅助aromatase inhibitors.MethodsWe纵向索赔数据从三个大型商业健康计划，估计坚持阿那曲唑治疗的妇女早期乳腺癌。依从性定义为观察期内患者有药物可用的天数比例（即，天覆盖）;妇女与少于80%的天覆盖被定义为nonadvertisement.ResultsMore 12，000妇女在数据库中被发现有新的阿那曲唑处方索赔期间的研究：在一个商业健康计划（A计划）数据集中，1,498名妇女被归类为患有早期疾病，在另一个计划（B计划）数据集中，1,899名妇女被归类为患有早期疾病，在MarketScan中，8,994名妇女被归类为患有早期疾病，由多个健康项目组成的商业数据集。在三个数据集中，治疗前12个月的平均依从性范围为82%至88%。19%至28%的妇女的保险天数不到80%。对于妇女与36个月的连续资格，平均遵守每年下降，范围从78%至86%，在第1年至62%至79%，在第3年内的三个datasets.ConclusionA相当大比例的妇女与早期乳腺癌可能是次优遵守辅助阿那曲唑治疗。未来的研究应该集中在识别有不依从口服激素治疗乳腺癌风险的患者，并制定干预措施以提高依从性。
PurposePrevious research evaluating adherence to tamoxifen therapy among women with early-stage breast cancer has revealed adherence estimates ranging from 25% to 96%. No previous studies have focused on adherence to adjuvant aromatase inhibitors.MethodsWe used longitudinal claims data from three large commercial health programs to estimate adherence with anastrozole therapy among women with early-stage breast cancer. Adherence was defined as the proportion of days that patients had medication available over the observation period ( ie, days covered); women with fewer than 80% of days covered were defined as nonadherent.ResultsMore than 12,000 women in the databases were found to have new anastrozole prescription claims during the period of study: 1,498 women were classified as having early-stage disease in one commercial health program ( Plan A) data set, 1,899 women in another program ( Plan B) data set, and 8,994 women in MarketScan, a commercial data set made up of several health programs. Mean adherence over the first 12 months of therapy ranged from 82% to 88% in the three data sets. Between 19% and 28% of women had fewer than 80% of days covered. For women with 36 months of continuous eligibility, the mean adherence decreased each year, ranging from 78% to 86% in year 1 to 62% to 79% in year 3 within the three data sets.ConclusionA substantial proportion of women with early-stage breast cancer may be suboptimally adherent to adjuvant anastrozole therapy. Future research should focus on the identification of patients at risk for nonadherence with oral hormonal therapy for breast cancer and the development of interventions to improve adherence.