Brunel University, Uxbridge, Middlesex, UK.
Eur J Cancer Care (Engl). 2012 Jan;21(1):10-9. doi: 10.1111/j.1365-2354.2011.01295.x. Epub 2011 Oct 18.
This review aimed to address the concept of adherence to adjuvant therapy in post-menopausal women. Thirteen studies were included in the review. Study quality was assessed using Critical Appraisal Skills Programme and CONSORT tools. Adherence to adjuvant medication was assessed using a variety of methods. Estimates of adherence rates to adjuvant therapies indicated that of the post-menopausal women prescribed adjuvant therapy, between 15% and 55% were adherent to tamoxifen from 1 to 5 years of follow-up, albeit two studies proposed adherence rates greater than 85%; these data may be flawed due to the methods of data collection. Between 31% and 73% of women were adherent to anastrozole, letrozole or exemestane from 1 year of treatment. These estimates of adherence are based on a variety of reported records including self-report. Current evidence on the assessment of adherence to adjuvant therapies in post-menopausal women indicate that the adherence rates of medication maybe suboptimal and therefore therapeutic efficacy is questionable and may increase the risk of cancer recurrence and reduce disease survival rates. Concerted research is needed to investigate adherence rates, examine patient health beliefs in the medication management of post-menopausal breast cancer patients and also develop new measures to assess adherence with medication.
这篇综述旨在探讨绝经后妇女辅助治疗依从性的概念。共纳入了 13 项研究。使用批判性评估技能计划和 CONSORT 工具评估研究质量。采用多种方法评估辅助药物的依从性。对辅助治疗依从率的估计表明，在接受辅助治疗的绝经后妇女中，有 15%至 55%的妇女在 1 至 5 年的随访期间依从他莫昔芬治疗，但有两项研究提出的依从率超过 85%；由于数据收集方法的原因，这些数据可能存在缺陷。有 31%至 73%的妇女在接受 1 年治疗后依从阿那曲唑、来曲唑或依西美坦。这些依从性估计是基于包括自我报告在内的各种报告记录得出的。目前关于绝经后妇女辅助治疗依从性的评估证据表明，药物的依从率可能不理想，因此治疗效果值得怀疑，并且可能增加癌症复发的风险，降低疾病生存率。需要开展协同研究，调查依从率，检查绝经后乳腺癌患者药物管理方面的患者健康信念，并开发新的措施来评估药物依从性。
