Fode Mikkel, Nielsen Torben K, Al-Hamadani Muhammad, Andersen Jesper R, Jakobsen Henrik, Sønksen Jens
Department of Urology, Herlev Hospital , Herlev , Denmark.
Scand J Urol. 2014 Apr;48(2):183-8. doi: 10.3109/21681805.2013.820789. Epub 2013 Jul 24.
The aim of this study was to assess patient preference regarding the length of treatment intervals of androgen deprivation therapy (ADT) with gonadotropin-releasing hormone agonists for prostate cancer.
The study was conducted as a questionnaire-based, cross-sectional study at a large university hospital. A specific questionnaire was developed based on current literature, clinical experience and a pilot phase of the study. The primary endpoint was preferred treatment frequency. Secondary outcome measures included reasons for preferred treatment frequency, treatment satisfaction and side-effects. Overall, 238 men receiving ADT for prostate cancer were presented with the questionnaire between September 2011 and May 2012. Descriptive statistics, the chi-squared test and multiple regression were used for analyses.
In total, 176 questionnaires (74%) were available for analysis. A total of 38.1% of participants preferred frequent treatment ("Every month", "Every third month"), 32.4% preferred infrequent treatment ("Every sixth month", "Every twelfth month") and 29.6% stated that length of the treatment intervals made no difference (p = 0.37). Patients with disease progression were most likely to prefer frequent treatment (odds ratio 4.4, 95% confidence interval 1.9-10.4). Overall, 84.1% were satisfied with treatment while one patient (0.6%) was dissatisfied. Nine per cent indicated severe side-effects.
Less frequent ADT treatment may help to lower the pressure on healthcare systems and may be of benefit for a large group of patients. However, it cannot be prescribed blindly without possibly affecting patient satisfaction. The choice of treatment intervals should be made in collaboration between the physician and the patient.
本研究旨在评估前列腺癌患者对于使用促性腺激素释放激素激动剂进行雄激素剥夺治疗(ADT)时治疗间隔时长的偏好。
本研究在一家大型大学医院以问卷调查的形式开展横断面研究。基于当前文献、临床经验以及研究的试点阶段制定了一份特定问卷。主要终点是偏好的治疗频率。次要结果指标包括偏好治疗频率的原因、治疗满意度和副作用。2011年9月至2012年5月期间,共有238名接受前列腺癌ADT治疗的男性接受了问卷调查。采用描述性统计、卡方检验和多元回归进行分析。
总共176份问卷(74%)可供分析。共有38.1%的参与者偏好频繁治疗(“每月一次”“每三个月一次”),32.4%偏好不频繁治疗(“每六个月一次”“每年一次”),29.6%表示治疗间隔时长并无差异(p = 0.37)。疾病进展的患者最有可能偏好频繁治疗(优势比4.4,95%置信区间1.9 - 10.4)。总体而言,84.1%的患者对治疗感到满意,而一名患者(0.6%)不满意。9%的患者表示有严重副作用。
减少ADT治疗频率可能有助于减轻医疗系统的压力,并且可能对一大群患者有益。然而,在不影响患者满意度的情况下不能盲目开处方。治疗间隔时长的选择应由医生和患者共同决定。