| Abstract | Drugi po redu uzročnik smrti u Hrvatskoj predstavljaju novotvorevine. Karcinom koji se najviše dijagnosticira kod žena je karcinom dojke te gotovo 70% pacijentica koje su oboljele od karcinoma dojke imaju hormonski ovisan tip karcinoma. Terapija hormonski ovisnog karcinoma dojke često obuhvaća AET. Adjuvantna endokrina terapija se sastoji od supresije jajnika, SERM-ova (tamoksifen) i AI (anastrozol, letrozol i eksemestan). Unatoč dokazanim koristima koji se postižu primjenom AET adherencija pacijentica nije zadovoljavajuća. Smatra se kako se uzrok tome može pronaći u dugom trajanju terapije, ali i u nuspojavama koje sama terapija uzrokuje. Cilj ovog diplomskog rada bilo je ustanoviti adherenciju pacijentica s HR+ karcinomom dojke koje se liječe adjuvantnom endokrinom terapijom. Istraživanje je dizajnirano kao presječno, opažajno u kojem su podatci prikupljeni u jednoj točci u vremenu. U istraživanju je sudjelovalo 353 ispitanice srednje dobi 54 (± 11,89) godine. Većina ispitanica bila je udana ili je živjelo u izvanbračnoj zajednici, visoko obrazovano te zaposleno na puno radno vrijeme. Postotak ispitanica koje je bilo na terapiji tamoksifenom je 39,1% dok je na terapiji AI bilo 55,0% ispitanica (23,8% anastrozol, letrozol 26,5%, eksemestan 4,7%). Za procjenu adherencije ispitanice su popunjavale validirani upitnik MARS_5. Ispitanice smo, s obzirom na njihove odgovore, bili podijelili na adherentne i neadherentne pacijentice. Rezultati MARS_5 upitnika su pokazali kako je adherentno bilo 53,0% ispitanica dok je neadherentno bilo 40,2% ispitanica (24,1%, nenamjerno neadherentno, 3,1%, namjerno neadherentno, 13,0% namjerno i nenamjerno neadherentno). Postoji značajna razlika u adherenciji između pacijentica koje su bile na terapiji AI (70,8%) u odnosu na one koje su bile na terapiji tamoksifenom (37,2%). Istraživanje ovakvog tipa na ženama koje su preboljele karcinom dojke te su trenutno na AET, prvi put je provedeno u Hrvatskoj. Ovo istraživanje doprinosi boljem razumijevanju adherencije žena koje su na AET te je važno identificirati razloge neadherencije pri AET te donijeti pravilne odluke o daljnjim intervencijama. |
| Abstract (english) | Second leading cause of death in Croatia is cancer. The most diagnosed carcinoma in women is breast cancer, almost 70% of patients with breast cancer have a hormon dependant breast cancer. Therapy for hormone-dependent breast cancer frequently include AET. Adjuvant endocrine therapy consists of ovarian suppression, SERMs (tamoxifen) and AI (anastrozole, letrozole and exemestane). Despite the proven benefits achieved by using AET, the adherence of patients is not satisfactory. It is believed that the cause of this can be found in the long duration of the therapy, but also in the side effects caused by the therapy itself. The goal of this thesis was to examine the adherence of patients with HR+ breast cancer treated with adjuvant endocrine therapy. The research was designed as a cross-sectional, observational study in which data were collected at one point in time. Research was conducted on 353 respondents with an average age of 54 (± 11,89). Most of the respondents were married or cohabiting, highly educated and were employed full-time. Percentage of subjects who were on tamoxifen therapy is 39,1%, while 55,0% of subjects were on AI therapy (23,8% anastrozole, 26,5% letrozole, 4,7% exemestane). To assess adherence, the subjects filled out the validated questionnaire MARS_5. Based on their answers, we divided the subjects into adherent and non-adherent patients. The results of the MARS_5 questionnaire showed that 53,0% of respondents were adherent, while 40,2% of respondents were non-adherent (24,1%, unintentionally non-adherent, 3,1%, intentionally non-adherent, 13,0% intentionally and unintentionally non-adherent). There was a significant difference in adherence between patients on AI therapy (70,8%) compared to those on tamoxifen therapy (37,2%). Research of this type on women who have survived breast cancer and are currently on AET was conducted for the first time in Croatia. This research contributes to a better understanding of the adherence of women who are on AET. It is important to identify why adherence to AET is so low and to make proper decisions about further interventions. |
