Smith, SG;
Foy, R;
McGowan, JA;
Kobayashi, LC;
de Censi, A;
Brown, K;
Side, L;
(2017)
Prescribing tamoxifen in primary care for the prevention of breast cancer: a national online survey of GPs' attitudes.
British Journal of General Practice
, 67
(659)
e414-e427.
10.3399/bjgp17X689377.
Preview |
Text
Prescribing tamoxifen in primary care for the prevention of breast cancer: a national online survey of GPs' attitudes.pdf - Published Version Download (154kB) | Preview |
Abstract
BACKGROUND: The cancer strategy for England (2015-2020) recommends GPs prescribe tamoxifen for breast cancer primary prevention among women at increased risk. AIM: To investigate GPs' attitudes towards prescribing tamoxifen. DESIGN AND SETTING: In an online survey, GPs in England, Northern Ireland, and Wales (n = 928) were randomised using a 2 × 2 between-subjects design to read one of four vignettes describing a healthy patient seeking a tamoxifen prescription. METHOD: In the vignette, the hypothetical patient's breast cancer risk (moderate versus high) and the clinician initiating the prescription (GP prescriber versus secondary care clinician [SCC] prescriber) were manipulated in a 1:1:1:1 ratio. Outcomes were willingness to prescribe, comfort discussing harms and benefits, comfort managing the patient, factors affecting the prescribing decision, and awareness of tamoxifen and the National Institute for Health and Care Excellence (NICE) guideline CG164. RESULTS: Half (51.7%) of the GPs knew tamoxifen can reduce breast cancer risk, and one-quarter (24.1%) were aware of NICE guideline CG164. Responders asked to initiate prescribing (GP prescriber) were less willing to prescribe tamoxifen than those continuing a prescription initiated in secondary care (SCC prescriber) (68.9% versus 84.6%, P<0.001). The GP prescribers reported less comfort discussing tamoxifen (53.4% versus 62.5%, P = 0.01). GPs willing to prescribe were more likely to be aware of the NICE guideline (P = 0.039) and to have acknowledged the benefits of tamoxifen (P<0.001), and were less likely to have considered its off-licence status (P<0.001). CONCLUSION: Initiating tamoxifen prescriptions for preventive therapy in secondary care before asking GPs to continue the patient's care may overcome some prescribing barriers.
| Type: | Article |
|---|---|
| Title: | Prescribing tamoxifen in primary care for the prevention of breast cancer: a national online survey of GPs' attitudes |
| Location: | England |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.3399/bjgp17X689377 |
| Publisher version: | http://doi.org/10.3399/bjgp17X689377 |
| Language: | English |
| Additional information: | Copyright © British Journal of General Practice 2017 This is an OpenAccess article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited. |
| Keywords: | Breast cancer, chemoprevention, general practice, preventive therapy, primary care, tamoxifen |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences > Experimental Psychology |
| URI: | https://discovery.ucl.ac.uk/id/eprint/1543226 |
Archive Staff Only
 |
View Item |
