[[alternative]]The Tamoxifen Adherence with Breast Cancer Patients in Taiwan

[[abstract]]目標：瞭解2003-2007年臺灣女性乳癌病患在術後服用tamoxifen之依從情形及比較依從者與非依從者在個人屬性與疾病特性之差異。方法：此回溯性世代追蹤研究，全國性資料源自2003年台灣癌症診療資料庫、2001-2004年全民健保資料庫及2003-2007年死亡檔。使用tamoxifen處方資訊計算藥品持有率（MPR）來反映病患接受輔助性荷爾蒙tamoxifen治療的依從情形。追蹤期間的平均藥品持有率變化趨勢亦被分析。此外，卡方及t- test用來比較依從與非依從者在個人及疾病特性之差異。結果：在2003年共有1487位女性乳癌病患口服tamoxifen做為術後輔助性荷爾蒙治療。研究對象之tamoxifen平均藥品持有率在術後半年達78%，但在追蹤四年期間有逐年下降的情形，至第四年底降為67%。在疾病特性及個人特性中，僅共病指數在tamoxifen依從及tamoxifen非依從兩組間有顯著差異。結論：臺灣乳癌病患的tamoxifen平均藥品持有率逐年下降，醫療照護者與病患間良好的溝通將有助於預防拒絕或斷斷續續服用tamoxifen治療的情形。[[abstract]]Objectives: To assess adherence to oral tamoxifen among women with breast cancer after surgical during 2003-2007 in Taiwan and to compare the differences between adherence and non-adherences groups in demographic and disease characteristics. Methods: Ａreprospective cohort study was conducted. Population-based data were retrieved from Taiwan Cancer Database (TCDB) in 2003, National Health Insurance Research Database (NHIRD) in 2002-2007 and Taiwan’s Death Registries in 2003-2007. The medication possession ratio (MPR) was used to assess patient adherence. Mean MPR change along patient follow up was analyzed. Additionaly, chi-square test and t- test were used to compare the differences between adherence and non-adherences groups in demographic and disease characteristics.Results: There were 1,487 women with breast cancer who received oral tamoxifen treatment after surgery in 2003. The mean MPR was about 78% in the first 6-month post operation, it gradually declined to 67% in the end of 4th year of follow up. As to demographic and disease characteristics, comorbidity was found significantly different between adherence and non-adherence groups. Conclusions: This study showed that adherence to oral tamoxifen declined along patient follow up among women with breast cancer after surgery. Better communication between health-care providers and patients should ultinmately help to prevent refusal or discontinuation of tamoxifen treatment