Ann Arbor VA HSR&D, Center for Clinical Management Research, Ann Arbor, MI, USA.
Breast Cancer Res Treat. 2010 Feb;119(3):613-20. doi: 10.1007/s10549-009-0618-4.
Tamoxifen reduces primary breast cancer incidence, yet causes serious side effects. To date, few women with increased breast cancer risk have elected to use tamoxifen for chemoprevention. The objective of the study was to determine women's knowledge of and attitudes toward tamoxifen following exposure to a tailored decision aid (DA). A total of 632 women with a 5-year risk of breast cancer > or = 1.66% (Mean = 2.56, range = 1.7-17.3) were recruited from two healthcare organizations. Participants viewed an online DA that informed them about their 5-year risk of breast cancer and presented individually tailored content depicting the risks/benefits of tamoxifen prophylaxis. Outcome measures included behavioral intentions (to seek additional information about tamoxifen, to talk to a physician about tamoxifen, and to take tamoxifen); knowledge; and perceived risks and benefits of tamoxifen. After viewing the DA, 29% of participants said they intended to seek more information or talk to their doctor about tamoxifen, and only 6% believed they would take tamoxifen. Knowledge was considerable, with 63% of women answering at least 5 of 6 knowledge questions correctly. Participants were concerned about the risks of tamoxifen, and many believed that the benefits of tamoxifen did not outweigh the risks. This study is the largest to date to test women's preferences for taking tamoxifen and one of the largest to have tested the impact of a tailored DA. After viewing the DA, women demonstrated good understanding of tamoxifen's risks and benefits, but most were not interested in taking tamoxifen for breast cancer chemoprevention.
他莫昔芬可降低原发性乳腺癌的发病率，但会引起严重的副作用。迄今为止，只有少数患有乳腺癌高风险的女性选择用他莫昔芬进行化学预防。本研究的目的是在使用定制化决策辅助工具（DA）后，确定女性对他莫昔芬的了解和态度。共有 632 名 5 年乳腺癌风险>或=1.66%的女性（平均值=2.56，范围=1.7-17.3），从两个医疗机构招募。参与者在线查看了一个 DA，该工具告知了他们的 5 年乳腺癌风险，并提供了个性化的内容，描述了他莫昔芬预防的风险/益处。结果包括行为意向（寻求有关他莫昔芬的更多信息、与医生讨论他莫昔芬以及服用他莫昔芬）；知识；以及对他莫昔芬的风险和益处的感知。观看 DA 后，29%的参与者表示他们打算寻求更多关于他莫昔芬的信息或与医生讨论他莫昔芬，只有 6%的人认为他们会服用他莫昔芬。知识水平相当高，有 63%的女性答对了至少 6 个知识问题中的 5 个。参与者担心他莫昔芬的风险，许多人认为他莫昔芬的益处并不大于风险。这是迄今为止最大规模的测试女性服用他莫昔芬的偏好的研究之一，也是最大规模的测试定制化 DA 影响的研究之一。观看 DA 后，女性对他莫昔芬的风险和益处有了很好的理解，但大多数女性对服用他莫昔芬预防乳腺癌不感兴趣。
