Department of Health Behavior and Policy, Virginia Commonwealth, University School of Medicine, P.O. Box 980149, Richmond, VA, 23219, USA.
Department of Pharmacotherapy & Outcomes Science, Virginia Commonwealth, University School of Pharmacy, Richmond, VA, USA.
Support Care Cancer. 2020 Sep;28(9):4147-4154. doi: 10.1007/s00520-019-05247-5. Epub 2020 Jan 2.
Adjuvant endocrine therapy (AET) reduces the risk of recurrence and mortality in women with hormone receptor-positive breast cancer. However, adherence to AET remains suboptimal. Women's beliefs about medication have been associated with medication adherence. The purpose of this study was to identify multilevel factors associated with women's beliefs about AET.
Beliefs about AET, measured using the Belief about Medicines Questionnaire (BMQ), sociodemographic (e.g., age), psychosocial (e.g., religiosity), and healthcare factors (e.g., patient-provider communication), were collected via survey. Clinical data were abstracted from medical records. Two stepwise regression analyses models were performed to assess relationships between variables and necessity and concern beliefs.
In our sample of 572 women, mean BMQ concern score was 11.19 and mean necessity score was 13.85 (range 5-20). In the regression models, higher ratings of patient-provider communication were associated with lower concern and higher necessity beliefs. Higher concern beliefs were related to more AET-related symptoms (Β = 0.08; 95% CI 0.06 to 0.10; p < 0.001), lower patient satisfaction (Β = - 0.07; 95% CI - 0.09 to - 0.04; p < 0.001), and higher religiosity (Β = 0.05; 95% CI 0.01 to 0.08; p = 0.007). Higher necessity beliefs were associated with prior chemotherapy use (Β = 0.11; 95% CI 0.06 to 0.16; p < 0.005) and less education (Β = 1.00; 95% CI 0.27 to 1.73; p = 0.008).
Modifiable factors are related to women's AET beliefs. Healthcare interactions may play a key role with regard to shaping women's beliefs about their AET medication.
辅助内分泌治疗(AET)可降低激素受体阳性乳腺癌患者的复发和死亡风险。然而,AET 的依从性仍然不理想。女性对药物的信念与药物依从性有关。本研究旨在确定与女性对 AET 的信念相关的多层次因素。
通过问卷调查,使用药物信念问卷(BMQ)测量 AET 信念、社会人口统计学(如年龄)、心理社会(如宗教信仰)和医疗保健因素(如医患沟通)。从病历中提取临床数据。进行了两项逐步回归分析模型,以评估变量与必要性和关注信念之间的关系。
在我们的 572 名女性样本中,BMQ 关注评分的平均值为 11.19,必要性评分为 13.85(范围为 5-20)。在回归模型中,更高的医患沟通评分与较低的关注和更高的必要性信念相关。更高的关注信念与更多的 AET 相关症状相关(β=0.08;95%CI 0.06 至 0.10;p<0.001)、较低的患者满意度(β=-0.07;95%CI-0.09 至-0.04;p<0.001)和更高的宗教信仰(β=0.05;95%CI 0.01 至 0.08;p=0.007)。更高的必要性信念与既往化疗使用(β=0.11;95%CI 0.06 至 0.16;p<0.005)和受教育程度较低(β=1.00;95%CI 0.27 至 1.73;p=0.008)相关。
可改变的因素与女性对 AET 治疗的信念有关。医疗保健互动可能在塑造女性对 AET 药物的信念方面发挥关键作用。