Milic Marina, Foster Anna, Rihawi Karim, Anthoney Alan, Twelves Chris
St James's Institute of Oncology, Leeds Teaching Hospitals Trust, Leeds, UK.
St James's Institute of Oncology, Leeds Teaching Hospitals Trust, Leeds, UK; Azienda Ospedaliero Universitaria Santa Maria della Misericordia, Udine, Italy.
Eur J Cancer. 2016 Mar;55:1-6. doi: 10.1016/j.ejca.2015.11.015. Epub 2015 Dec 28.
The implications for patients with cancer, of the 'tablet burden' resulting from increasing use of oral anticancer drugs and medication for co-morbidities have not previously been well explored.
We sought to (i) quantify tablet burden in women with metastatic breast cancer (MBC), (ii) establish which groups of drug contribute most to this burden and (iii) gain insight into patients' attitudes towards oral anti-cancer treatment.
One hundred patients with MBC anonymously completed a questionnaire describing their medication histories and attitudes towards their tablets.
The patients (mean age 60, range 31-95) were all female and taking a median of six tablets (range 0-31) daily; 37 patients were taking >10 tablets. Oral anticancer treatment constituted the category of treatment taken by the highest proportion of patients, followed by symptomatic cancer treatments, proton pump inhibitors and cardiovascular medication. Numerically, however, symptomatic drugs accounted for 44% of all tablets and specific anti-cancer treatment for 15%; medication not directly related to the cancer accounted for the remaining 40% of tablets. A quarter of patients reported inconvenience in taking their tablets, the main reason being tablet size and one third reported forgetting their tablets at least once a week. Nearly two thirds of patients expressing a preference favoured oral anticancer treatment, the commonest reason being greater convenience.
Tablet burden is considerable for many patients with MBC and can be problematic. A significant proportion of tablets represent treatment for co-morbidities, the significance of which may be questionable in women with MBC.
口服抗癌药物使用增加以及用于治疗合并症的药物所导致的“药片负担”对癌症患者的影响,此前尚未得到充分研究。
我们试图(i)量化转移性乳腺癌(MBC)女性患者的药片负担,(ii)确定哪类药物对这种负担的影响最大,以及(iii)深入了解患者对口服抗癌治疗的态度。
100例MBC患者匿名填写了一份问卷,描述他们的用药史和对药片的态度。
患者(平均年龄60岁,范围31 - 95岁)均为女性,每天服用药片的中位数为6片(范围0 - 31片);37例患者服用超过10片。口服抗癌治疗是患者服用比例最高的治疗类别,其次是癌症对症治疗、质子泵抑制剂和心血管药物。然而,从数量上看,对症药物占所有药片的44%,特定抗癌治疗占15%;与癌症无直接关系的药物占其余的40%。四分之一的患者报告服药不便,主要原因是药片大小;三分之一的患者报告每周至少有一次忘记服药。近三分之二表示有偏好的患者倾向于口服抗癌治疗,最常见的原因是更方便。
对于许多MBC患者来说,药片负担相当大且可能存在问题。相当一部分药片是用于治疗合并症的,其在MBC女性患者中的重要性可能值得质疑。