Adherence Among Older Women with Breast Cancer

描述（由申请人提供）：该职业发展奖的目的是为Sharon Giordano博士提供必要的经验和知识，使其成为乳腺癌领域的独立卫生服务研究人员。佐丹奴博士是一名医学肿瘤学家和公共卫生硕士候选人，他将通过指导阅读、研讨会、课程作业和指导研究的结合来实现这一目标。一个高素质的导师团队将监督她的培训，确保她实现自己的目标。Giordano博士将使用两种不同的方法来检查老年乳腺癌妇女对标准辅助治疗的依从性：使用SEER-Medicare数据库的二次数据分析和主要数据收集。这个的具体目的

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.