RESUMEN
PURPOSE: This pilot study evaluated adherence to anti-estrogen therapy in women with hormone receptor-positive breast cancer utilizing bubble packaging. METHODS: This was a single-arm prospective investigational pilot study that enrolled 86 patients between August 2012 and April 2014. Descriptive statistics for patient age, race, insurance, stage, duration of treatment, and comorbidities were computed. All patients received routine prescriptions in a "bubble" pack or daily blister pack dispensed by one pharmacy. Participants were considered adherent if they had taken ≥ 80% of the dispensed drug. Disease-free survival (DFS) and overall survival (OS) data were obtained at 78 months. RESULTS: Fifty patients were included in the analysis. The overall adherence rate was 97%. None of the variables examined (race, age, insurance status, and stage) had an impact on adherence rate. Only duration of endocrine therapy had a marginal effect on adherence (p value = 0.06). The late cohort (duration of therapy 37-60 months) was least likely to be compliant at 89.53%. Our 5-year DFS was 94% and 5-year OS was 96%. There was no statistically significant difference in DFS and OS between patients with adherence rate > 90% and < 90%. CONCLUSION: Adherence rate to bubble packaging was higher than that in historical studies. Although this is a single-arm pilot study, these data suggest bubble packaging of anti-estrogen may be a reasonable option to improve adherence in hormone receptor-positive breast cancer patients.
Asunto(s)
Antineoplásicos Hormonales/administración & dosificación , Neoplasias de la Mama/tratamiento farmacológico , Neoplasias de la Mama/metabolismo , Cumplimiento de la Medicación , Receptores de Estrógenos/metabolismo , Receptores de Progesterona/metabolismo , Adulto , Anciano , Anciano de 80 o más Años , Antineoplásicos Hormonales/efectos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Neoplasias de la Mama/mortalidad , Neoplasias de la Mama/patología , Terapia Combinada , Comorbilidad , Femenino , Humanos , Persona de Mediana Edad , Estadificación de Neoplasias , Proyectos Piloto , Receptores de Estrógenos/genética , Receptores de Progesterona/genética , Resultado del TratamientoRESUMEN
The family Cactaceae Juss. contains some of the most widespread and damaging invasive alien plant species in the world, with Australia (39 species), South Africa (35) and Spain (24) being the main hotspots of invasion. The Global Cactus Working Group (IOBC GCWG) was launched in 2015 to improve international collaboration and identify key actions that can be taken to limit the impacts caused by cactus invasions worldwide. Based on the results of an on-line survey, information collated from a review of the scientific and grey literature, expertise of the authors, and because invasiveness appears to vary predictably across the family, we (the IOBC GCWG): (1) recommend that invasive and potentially invasive cacti are regulated, and to assist with this propose five risk categories; (2) recommend that cactus invasions are treated physically or chemically before they become widespread; (3) advocate the use of biological control to manage widespread invasive species; and (4) encourage the development of public awareness and engagement initiatives to integrate all available knowledge and perspectives in the development and implementation of management actions, and address conflicts of interest, especially with the agricultural and ornamental sectors. Implementing these recommendations will require global co-operation. The IOBC GCWG aims to assist with this process though the dissemination of information and experience.