目的:辅助内分泌治疗(AET)降低乳腺癌发病率和死亡率,然而,女性经常报告依从性欠佳。虽然AET依从性的相关性是有据可查的,很少有研究研究与依从性相关的多水平因素的相对重要性。这项研究的目的是确定与乳腺癌女性AET依从性最密切相关的因素。
方法:在2019年10月至2021年6月之间,非转移性女性(N=100),激素受体阳性乳腺癌,将报告AET相关痛苦的AET纳入临床试验。参与者完成了基线测量,包括药物依从性评定量表-5,社会人口统计学,和有效的焦虑测量,抑郁症,服药自我效能感,社会支持,和治疗满意度。我们创造了一个潜在的因素,并测试了社会人口统计学,medical,和社会心理特征和坚持。相关预测因子(p<.10)被输入到结构模型中,这通过多元回归模型得到了证实。
结果:四指标潜在粘附因子显示出良好的模型拟合。参与者(法师=56.1岁,91%的白人)失业的人(B=0.27,SE=0.13,p=0.046)并报告了更大的治疗便利性(B=0.01,SE=0.01,p=0.046)报告了更大的依从性。报告服药自我效能(p=0.097)和社会支持(p=0.062)的参与者分数接近更好的依从性。更高的服药自我效能(B=0.08,SE=0.02,p<.001)和失业(B=0.28,SE=.14,p=.042)与更高的依从性密切相关,独立于其他预测因素。多变量建模证实了类似的发现。
结论:服药自我效能和就业状况与AET依从性相关,高于其他相关因素。
结论:增强患者对乳腺癌患者服用AET能力的信心可能是提高依从性的重要干预目标。
OBJECTIVE: Adjuvant endocrine therapy (AET) reduces breast cancer morbidity and mortality, yet women often report suboptimal adherence. Though correlates of AET adherence are well-documented, few studies examine the relative importance of multi-level factors associated with adherence. The aim of this study was to identify factors most strongly associated with AET adherence in women with breast cancer.
METHODS: Between 10/2019 and 6/2021, women (N = 100) with non-metastatic, hormone receptor-positive breast cancer, taking AET who reported AET-related distress enrolled into a clinical trial. Participants completed baseline measures, including the Medication Adherence Rating Scale-5, sociodemographics, and validated measures of anxiety, depression, medication-taking self-efficacy, social support, and treatment satisfaction. We created a latent factor and tested associations between sociodemographic, medical, and psychosocial characteristics and adherence. Associated predictors (p < .10) were entered into a structural model, which was corroborated via multivariate regression modeling.
RESULTS: A four-indicator latent adherence factor demonstrated good model fit. Participants (Mage = 56.1 years, 91% White) who were unemployed (B = 0.27, SE = 0.13, p = .046) and reported greater treatment convenience (B = 0.01, SE = 0.01, p = .046) reported greater adherence. Scores of participants who reported greater medication-taking self-efficacy (p = .097) and social support (p = .062) approached better adherence. Greater medication-taking self-efficacy (B = 0.08, SE = 0.02, p < .001) and being unemployed (B = 0.28, SE = .14, p = .042) were most strongly associated with greater adherence, independent of other predictors. Multivariate modeling confirmed similar findings.
CONCLUSIONS: Medication-taking self-efficacy and employment status were associated with AET adherence above other related factors.
CONCLUSIONS: Enhancing patients\' confidence in their ability to take AET for breast cancer may represent an important intervention target to boost adherence.