目的:本研究旨在调查前列腺癌患者对雄激素剥夺治疗(ADT)的选择以及影响其ADT偏好的可能因素。
方法:这是一项单中心横断面研究,调查ADT的使用和偏好。连续接受可注射黄体生成素释放激素(LHRH)激动剂或拮抗剂的前列腺癌患者从三级学术医院的前列腺癌诊所招募。接受双侧睾丸切除术的患者或不同意该研究的患者被排除。疾病特征,记录治疗信息和患者背景.调查收集了与他们改变ADT方案有关的信息,对药物使用的偏好(给药途径和频率)及其原因。设计了一组假设的三种药物配方。关于患者偏好的问题和问卷格式中提出的促成原因。
结果:100名患者完成了调查。大多数患者开始注射更频繁(3个月,54%;1个月,38%),并在调查时切换为6个月注射(89%)。变化的主要原因是医疗保健意见(72%)和治疗频率较低(51%)。ADT的三种选择(每日口服,提供了1个月和6个月的注射),具有相同的功效和副作用:61%的首选6个月的注射,1%的人首选每月一次注射,38%的人首选口服方案。当患者在1个月注射或每日口服药物中被告知心血管副作用较低时,患者偏好为56%(6个月),6%(每月一次),39%(口服)。多重用药(超过5种常规药物)的患者更倾向于选择注射(p=0.025)。患者年龄,教育背景,就业状况,未发现婚姻状况和疾病状况是影响患者偏好的统计学显著因素.
结论:尽管心血管风险更大,但6个月的ADT注射是首选的ADT。在每月或每天口服LHRH拮抗剂中,更多的患者更喜欢口服。便利因素受到高度重视。
OBJECTIVE: The study aimed at investigating prostate cancer patients\' choice of androgen deprivation treatment (ADT) and possible factors that would affect their preferences of ADT.
METHODS: This was a single-centre cross-sectional study investigating the usage and preferences of ADT. Consecutives prostate cancer patients who were receiving injectable luteinizing hormone-releasing hormone (LHRH) agonist or antagonist were recruited from the prostate cancer clinic in a tertiary academic hospital. Patients who received bilateral orchidectomy or those who could not consent to the study were excluded. Disease characteristics, treatment information and patient background were documented. The survey collected information related to their change in ADT regimen, preferences on drug usage (routes and frequency of administration) and their reasons. A hypothetical set of three drug formularies was designed. Questions regarding patient preference and the contributing reasons raised in the format of questionnaire.
RESULTS: 100 patients completed the survey. Most patients started with more frequent injections (3-monthly, 54%; 1-monthly, 38%) and switched to 6-monthly injections (89%) at the time of the survey. Primary reasons for the change were healthcare opinion (72%) and less frequent treatment (51%). Three options of ADT (oral daily, 1-monthly and 6-monthly injection) with the same efficacies and side effect profile were offered: 61% preferred 6-monthly injection, 1% preferred 1-monthly injection and 38% preferred oral regimen. When patients were informed of lower cardiovascular side effects in 1-monthly injection or daily oral drug, patients\' preference was 56% (6-monthly), 6% (1-monthly), and 39% (oral). Patients with polypharmacy (more than 5 regular medications) were more inclined to choose injections (p = 0.025). Patient age, educational background, employment status, marriage status and disease status were not found to be statistically significant contributing factors to patient preference.
CONCLUSIONS: 6-monthly ADT injection was the preferred ADT despite greater cardiovascular risks. Among 1-monthly or daily oral LHRH antagonist, more patients prefer oral option. Convenience factor was highly valued.