Adesão à Terapia Hormonal Adjuvante com Tamoxifeno e Anastrozol utilizando ARMS-12 e MMAS-4
DOI:
https://doi.org/10.32635/2176-9745.RBC.2022v68n2.1960Palavras-chave:
adesão à medicação, cooperação do paciente, anastrozol/uso terapêutico, tamoxifeno/uso terapêutico, neoplasia da mamaResumo
Introdução: Entre os canceres de mama, aproximadamente 75% das mulheres são receptores hormonais positivos, sendo estas mais propensas a responderem a hormonioterapia com anastrozol e tamoxifeno. Apesar de eficazes, apresentam taxas significativas de não adesão. Objetivo: Avaliar a adesão a terapia hormonal adjuvante com tamoxifeno e anastrozol em pacientes atendidos nos Ambulatórios da Mastologia e de Quimioterapia do Hospital São Paulo entre os anos de 2019 e 2020. Método: Estudo transversal com 102 mulheres, realizado entre os meses de setembro de 2019 e marco de 2020. A adesão a terapia hormonal adjuvante foi avaliada utilizando-se as escalas Morisky Medication Adherence Scale (MMAS-4) e Adherence to Refills and Medications Scale of 12 items (ARMS-12). Resultados: A média de idade foi de 61,5 anos (59,3-63,6). Entre as pacientes, 27,7% faziam uso de tamoxifeno e 72,3% de anastrozol. Relataram desconforto em relação ao uso do medicamento 84,4%, sendo as ondas de calor (42,2%) e as dores articulares (55,9%) os mais frequentes. A escala de ARMS>12 foi pontuada por 79,2%; cerca de 90% das mulheres pontuaram a MMAS-4 até dois pontos, porém não houve diferença significativa entre os tipos de hormônios utilizados para escalas de adesão (p=0,815 e p=0,489). Conclusão: A adesão a hormonioterapia observada foi relativamente baixa, independentemente da endocrinoterapia, podendo essas pacientes estarem em risco de inadequação quanto a resposta clínica.
Downloads
Referências
Instituto Nacional de Câncer José Alencar Gomes da Silva. Estimativa 2020: incidência de câncer no Brasil [Internet]. Rio de Janeiro: INCA; 2019 [acesso 2020 abr 10]. Disponível em: https://www.inca.gov.br/sites/ufu.sti.inca.local/files/media/document/estimativa-2020-incidencia-de-cancer-no-brasil.pdf
Waks AG, Winer EP. Breast cancer treatment: a review. JAMA. 2019;321(3):288-300. doi: https://doi.org/10.1001/jama.2018.19323 DOI: https://doi.org/10.1001/jama.2018.19323
Hagen KB, Aas T, Kavaløy JT et al. Adherence to adjuvant endocrine therapy in postmenopausal breast cancer patients: a 5-year prospective study. Breast. 2019;44:52-8. doi: https://doi.org/10.1016/j.breast.2019.01.003 DOI: https://doi.org/10.1016/j.breast.2019.01.003
Cheung WY, Lai EC, Ruan JY, et al. Comparative adherence to oral hormonal agents in older women with breast cancer. Breast Cancer Res Treat. 2015;152(2):419-27. doi: https://doi.org/10.1007/s10549-015-3455-7 DOI: https://doi.org/10.1007/s10549-015-3455-7
Osterberg L, Blaschke T. Adherence to medication. N Engl J Med. 2005;353(5):487-97. doi: https://doi.org/10.1056/NEJMra050100 DOI: https://doi.org/10.1056/NEJMra050100
Nguyen TM, La Caze A, Cottrell N. What are validated self-report adherence scales really measuring?: a systematic review. Br J Clin Pharmacol. 2014;77(3):427-45. doi: https://doi.org/10.1111/bcp.12194 DOI: https://doi.org/10.1111/bcp.12194
Murphy CC, Bartholomew LK, Carpentier MY, et al. Adherence to adjuvant hormonal therapy among breast cancer survivors in clinical practice: a systematic review. Breast Cancer Res Treat. 2012 Jul;134(2):459-78. doi: https://doi.org/10.1007/s10549-012-2114-5 DOI: https://doi.org/10.1007/s10549-012-2114-5
Xu S, Yang Y, Tao W, et al. Tamoxifen adherence and its relationship to mortality in 116 men with breast cancer. Breast Cancer Res Treat. 2012;136(2):495-502. doi: https://doi.org/10.1007/s10549-012-2286-z DOI: https://doi.org/10.1007/s10549-012-2286-z
Stahlschmidt R, Ferracini AC, Souza CM, et al. Adherence and quality of life in women with breast cancer being treated with oral hormone therapy. Support Care Cancer. 2019;27(10):3799-3804. doi: https://doi.org/10.1007/s00520-019-04671-x DOI: https://doi.org/10.1007/s00520-019-04671-x
Gökdoğan F, Kes D. Validity and reliability of the Turkish adherence to refills and medications scale. Int J Nurs Pract. 2017;23(5). doi: https://doi.org/10.1111/ijn.12566 DOI: https://doi.org/10.1111/ijn.12566
Lam WY, Fresco P. Medication adherence measures: an overview. Biomed Res Int. 2015;2015:217047. doi: https://doi.org/10.1155/2015/217047 DOI: https://doi.org/10.1155/2015/217047
Pourcelot C, Orillard E, Nallet G, et al. Adjuvant hormonal therapy for early breast cancer: an epidemiologic study of medication adherence. Breast Cancer Res Treat. 2018;169(1):153-62. doi: https://doi.org/10.1007/s10549-018-4676-3 DOI: https://doi.org/10.1007/s10549-018-4676-3
Birand N, Boşnak AS, Diker Ö, et al. The role of the pharmacist in improving medication beliefs and adherence in cancer patients. J Oncol Pharm Pract. 2019;25(8):1916-26. doi: https://doi.org/10.1177/1078155219831377 DOI: https://doi.org/10.1177/1078155219831377
Ali EE, Cheung KL, Lee CP, et al. Prevalence and determinants of adherence to oral adjuvant endocrine therapy among breast cancer patients in Singapore. Asia Pac J Oncol Nurs. 2017;4(4):283-9. doi: https://doi.org/10.4103/2347-5625.212864 DOI: https://doi.org/10.4103/2347-5625.212864
Marques PAC, Pierin AMG. Fatores que influenciam a adesão de pacientes com câncer à terapia antineoplásica oral. Acta Paul Enferm. 2008;21(2):323-9. doi: https://doi.org/10.1590/S0103-21002008000200015 DOI: https://doi.org/10.1590/S0103-21002008000200015
Aguiar KS. Validação de uma versão em português do instrumento Adherence to Refills and Medications Scale (ARMS) para avaliação de adesão ao tratamento com antineoplásicos orais [dissertação na Internet]. Curitiba: Universidade Federal do Paraná; 2019 [acesso 2021 jan 12]. Disponível em: https://hdl.handle.net/1884/60845
Lebrão ML, Laurenti R. Saúde, bem-estar e envelhecimento: o estudo SABE no município de São Paulo. Rev Bras Epidemiol. 2005;8(2):127-41. doi: https://doi.org/10.1590/S1415-790X2005000200005 DOI: https://doi.org/10.1590/S1415-790X2005000200005
Morisky DE, Green LW, Levine DM. Concurrent and predictive validity of a self-reported measure of medication adherence. Med Care. 1986;24(1):67-74. doi: https://doi.org/10.1097/00005650-198601000-00007 DOI: https://doi.org/10.1097/00005650-198601000-00007
Kripalani S, Risser J, Gatti ME, et al. Development and evaluation of the Adherence to Refills and Medications Scale (ARMS) among low-literacy patients with chronic disease. Value Health. 2009;12(1):118-23. doi: https://doi.org/10.1111/j.1524-4733.2008.00400.x DOI: https://doi.org/10.1111/j.1524-4733.2008.00400.x
Park HY, Seo SA, Yoo H, et al. Medication adherence and beliefs about medication in elderly patients living alone with chronic diseases. Patient Prefer Adherence. 2018;12:175-81. doi: https://doi.org/10.2147/PPA.S151263 DOI: https://doi.org/10.2147/PPA.S151263
Sestak I, Smith SG, Howell A, et al. Early participant-reported symptoms as predictors of adherence to anastrozole in the International Breast Cancer Intervention Studies II. Ann Oncol. 2018;29(2):504-9. doi: https://doi.org/10.1093/annonc/mdx713 DOI: https://doi.org/10.1093/annonc/mdx713
Paranjpe R, John G, Trivedi M, et al. Identifying adherence barriers to oral endocrine therapy among breast cancer survivors. Breast Cancer Res Treat. 2019;174(2):297-305. doi: https://doi.org/10.1007/s10549-018-05073-z DOI: https://doi.org/10.1007/s10549-018-05073-z
Mohamed KEH, Elamin A. Adherence to endocrine therapy and its relation to disease-free survival among breast cancer patients visiting an out-patient clinic at Khartoum Oncology Hospital, Sudan. J Eval Clin Pract. 2020;26(6):1731-43. doi: https://doi.org/10.1111/jep.13373 DOI: https://doi.org/10.1111/jep.13373
Wulaningsih W, Garmo H, Ahlgren J, et al. Determinants of non-adherence to adjuvant endocrine treatment in women with breast cancer: the role of comorbidity. Breast Cancer Res Treat. 2018;172(1):167-77. doi: https://doi.org/10.1007/s10549-018-4890-z DOI: https://doi.org/10.1007/s10549-018-4890-z
Leite FMC, Bubach S, Amorim MHC, et al. Mulheres com diagnóstico de câncer de mama em tratamento com tamoxifeno: perfil sociodemográfico e clínico. Rev Bras Cancerol. 2011;57(1):15-1. doi: https://doi.org/10.32635/2176-9745.RBC.2011v57n1.680 DOI: https://doi.org/10.32635/2176-9745.RBC.2011v57n1.680
Blanchette PS, Lam M, Richard L, et al. Factors associated with endocrine therapy adherence among post-menopausal women treated for early-stage breast cancer in Ontario, Canada. Breast Cancer Res Treat. 2020;179(1):217-27. doi: https://doi.org/10.1007/s10549-019-05430-6 DOI: https://doi.org/10.1007/s10549-019-05430-6
Tenti S, Correale P, Cheleschi S, et al. Aromatase inhibitors-induced musculoskeletal disorders: current knowledge on clinical and molecular aspects. Int J Mol Sci. 2020;21(16):5625. doi: https://doi.org/10.3390/ijms21165625 DOI: https://doi.org/10.3390/ijms21165625
Berkowitz MJ, Thompson CK, Zibecchi LT, et al. How patients experience endocrine therapy for breast cancer: an online survey of side effects, adherence, and medical team support. J Cancer Surviv. 2021;15(1):29-39. doi: https://doi.org/10.1007/s11764-020-00908-5 DOI: https://doi.org/10.1007/s11764-020-00908-5
Verbrugghe M, Verhaeghe S, Decoene E, et al. Factors influencing the process of medication (non-)adherence and (non-)persistence in breast cancer patients with adjuvant antihormonal therapy: a qualitative study. Eur J Cancer Care (Engl). 2017;26(2). doi: https://doi.org/10.1111/ecc.12339 DOI: https://doi.org/10.1111/ecc.12339
Milata JL, Otte JL, Carpenter JS. Oral endocrine therapy nonadherence, adverse effects, decisional support, and decisional needs in women with breast cancer. Cancer Nurs. 2018;41(1):E9-E18. doi: https://doi.org/10.1097/NCC.0000000000000430 DOI: https://doi.org/10.1097/NCC.0000000000000430
Chlebowski RT, Geller ML. Adherence to endocrine therapy for breast cancer. Oncology. 2006;71(1-2):1-9. doi: https://doi.org/10.1159/000100444 DOI: https://doi.org/10.1159/000100444
Banning M. Adherence to adjuvant therapy in post-menopausal breast cancer patients: a review. Eur J Cancer Care (Engl). 2012;21(1):10-9. doi: https://doi.org/10.1111/j.1365-2354.2011.01295.x DOI: https://doi.org/10.1111/j.1365-2354.2011.01295.x
Grunfeld EA, Hunter MS, Sikka P, et al. Adherence beliefs among breast cancer patients taking tamoxifen. Patient Educ Couns. 2005;59(1):97-102. doi: https://doi.org/10.1016/j.pec.2004.10.005 DOI: https://doi.org/10.1016/j.pec.2004.10.005
Downloads
Publicado
Como Citar
Edição
Seção
Licença
Os direitos morais e intelectuais dos artigos pertencem aos respectivos autores, que concedem à RBC o direito de publicação.
Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.
