Adherence and discontinuation of adjuvant hormonal therapy in breast cancer patients: a population-based study
Autor: | Johan Ahlgren, Jan Adolfsson, Leif Bergkvist, Tommy Fornander, Annette Wigertz, Mats Lambe, Henrik Lindman, Marit Holmqvist |
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Rok vydání: | 2012 |
Předmět: |
Adult
Cancer Research medicine.medical_specialty Neoplasms Hormone-Dependent Multivariate analysis Antineoplastic Agents Hormonal medicine.drug_class Population Breast Neoplasms Maintenance Chemotherapy Medication Adherence Breast cancer Internal medicine Humans Medicine Medical prescription education Aged Aged 80 and over Sweden Gynecology education.field_of_study Aromatase inhibitor Aromatase Inhibitors business.industry Middle Aged medicine.disease Discontinuation Tamoxifen Logistic Models Oncology Chemotherapy Adjuvant Multivariate Analysis Hormonal therapy Female Neoplasm Recurrence Local business medicine.drug |
Zdroj: | Breast Cancer Research and Treatment. 133:367-373 |
ISSN: | 1573-7217 0167-6806 |
Popis: | Adherence to long-term pharmacological treatment for chronic conditions is often less than optimal. Till date, a limited number of population-based studies have assessed adherence to adjuvant hormonal therapy in breast cancer, a therapy with proven benefits in terms of reductions of recurrence and mortality. We aimed to examine rates of adherence and early discontinuation in Sweden where prescribed medications are subsidized for all residents and made available at reduced out-of-pocket costs. Individual-level data were obtained from Regional Clinical Quality Breast Cancer Registers, the Swedish Prescribed Drug Register, and several other population-based registers. Multivariate logistic regression was used to analyze factors associated with adherence to prescribed medication for a period of 3 years. Between January 1 and December 31, 2005, 1,741 patients in central Sweden were identified with estrogen receptor positive breast cancer, and at least one prescription dispensation of either tamoxifen or an aromatase inhibitor. Of these women, 1,193 (69%) were fully adherent to therapy for 3 years (medication possession ratio of 80% or higher and a maximum of 180 days between refills). During the 3-year follow-up, 215 women (12%) had prematurely discontinued therapy. Adherence was positively associated with younger age, large tumor size, being married, and being born in the Nordic countries, while no clear association was observed with education or income. During the 3 years of follow-up, 31% of women were non-adherent to therapy. Further efforts must be undertaken to promote adherence over the entire recommended treatment period. |
Databáze: | OpenAIRE |
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