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Prescribing Advice for GPs

An NHS Prescribing Advisers' Blog

Poor compliance affects cancer survival

The British Journal of Cancer has published the results of a retrospective cohort study that aimed to assess whether women prescribed tamoxifen after surgery for breast cancer adhered to their prescription and whether adherence influenced survival.

The study identified 2,080 women diagnosed with breast cancer in the Tayside region of Scotland between 1993 and 2002. 79% (1,633) of these women were prescribed tamoxifen with the median duration of treatment being 2.4 years.

The study found an association between longer treatment and better survival. There was also a statistically significant increase in the risk of death for patients who had less than 80% compliance (missing more than one tablet in five). The study also found that less than half (49%) of patients completed the recommended 5 years of treatment with tamoxifen.

The authors conclude that, "a significant proportion of women have low adherence to tamoxifen and are at increased risk of death".

Action: Clinicians should be aware of the potential for poor compliance. Patients should be informed that better compliance with treatment improves survival.

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