Adherence Among Older Women with Breast Cancer

描述（由申请人提供）：这个职业发展奖的目的是提供博士沙龙佐丹奴必要的经验和知识，成为一个独立的健康服务研究人员在乳腺癌领域。 佐丹奴，谁是医学肿瘤学家和公共卫生硕士候选人，将通过定向阅读，研讨会，课程和指导研究的组合来实现这一目标。 一个高素质的导师团队将监督她的培训，并确保她达到她的目标。 Giordano博士将使用两种不同的方法来检查老年乳腺癌女性辅助治疗标准疗程的依从性：使用SEER-Medicare数据库和主要数据收集进行的次要数据分析。 具体目标是 建议如下：1）描述老年乳腺癌患者中缺乏化疗和放疗依从性的人群样本; 2）确定特定合并症以及患者、医生和环境特征对化疗和放疗依从性的影响;和3）前瞻性地识别因素，包括抑郁症和痴呆症的潜在未被识别的共病，影响老年乳腺癌患者治疗依从性的因素。 前两个具体目标将使用基于人口的SEER医疗保险数据库来实现，第三个具体目标将通过前瞻性研究来实现。 拟议的研究将提供重要的知识，关于模式和预测因素，坚持辅助治疗的老年妇女。 此外，这些研究将为申请人提供使用癌症登记数据和索赔数据、原始数据收集和数据分析方面的专业知识。 拟议的研究和职业发展活动将为申请人提供发展成为独立调查员的技能。

DESCRIPTION (provided by applicant): The objective of this career development award is to provide Dr. Sharon Giordano with the experience and knowledge necessary to become an independent health services researcher in the field of breast cancer. Dr. Giordano, who is a medical oncologist and MPH candidate, will accomplish this goal through a combination of directed reading, seminars, coursework, and mentored research. A highly qualified team of mentors will supervise her training and ensure that she meets her goals. Dr. Giordano will be examining adherence to a standard course of adjuvant treatment among older women with breast cancer using two different approaches: secondary data analyses using the SEER-Medicare database and primary data collection. The specific aims of this proposal are: 1 ) to describe lack of adherence to chemotherapy and radiotherapy in a population-based sample of older women with breast cancer; 2) to determine the effect of specific comorbidities as well as patient, physician, and environmental characteristics on adherence to chemotherapy and radiotherapy; and 3) to prospectively identify factors, including the potentially unrecognized comorbidities of depression and dementia, that affect adherence to therapy in older women with breast cancer. The first two specific aims will be accomplished using the population-based SEER-Medicare database, and the third specific aim through a prospective study. The proposed research will provide important knowledge regarding the patterns and predictors of adherence to adjuvant therapy among older women. In addition, these studies will provide the applicant with expertise in the use of cancer registry data and claims data, in primary data collection, and in data analysis. The proposed studies and career development activities will provide the applicant with the skills to develop into an independent investigator.