Exploring prescribing patterns, treatment trajectory and healthcare resources use of breast cancer patients in primary care to inform community pharmacy services for breast cancer survivors in England

Application Number
16_202
Lay Summary

As treatments improve and cancer is discovered earlier, people are living for longer with breast cancer. People living with breast cancer, or survivors as they are known, often need to take medicines for many years and say that they would like more support after returning home from hospital. The increased demand for breast cancer survivors to be looked after by general practitioners and other community-based professionals has allowed community pharmacy to take on a larger role in providing support. To facilitate the development of community pharmacy services for breast cancer survivors, research into the medicines people take and the care they need is required. This study will use data from England’s general practitioner records to explore the characteristics of breast cancer survivors and the medicines they take, in order to understand their treatments and what support they need when taking medicines over long periods of time. This study will form part of a larger research project aiming to develop a community pharmacist-led approach to providing support and improving the health of people with breast cancer. Future research will then explore how these needs might be addressed by a future community pharmacy-based service.

Technical Summary

The improvement in breast cancer survival has led to an increasing demand for breast cancer focused primary care services due to the increasing requirements of long-term breast cancer therapy and survivor support. Therefore, there is a scope for community pharmacy to take on a larger role. To facilitate the development of pharmacy services for breast cancer survivors, research into current treatment pathways and care needs is required. This retrospective cohort study aims to explore medicine utilisation patterns and treatment trajectory for breast cancer survivors in England’s primary care setting using the Clinical Practice Research Datalink data from November 2005 to October 2015. Newly diagnosed female breast cancer patients will be selected and followed from the date of discharge from hospital after initial breast cancer treatment until either leaving their general practice; death; or the end of the study. Patients with a 2-10 year follow-up period will be included and their characteristics (i.e. age at baseline, ethnicity, follow-up and survival duration), medicine utilisation patterns (endocrine therapy and exposure time, interruptions, and commonly prescribed non-cancer-related prescriptions), follow-up endpoint, medical resource use (primary and secondary care visits, and cancer care review) will be measured and analysed by descriptive statistics and regression methods.

Collaborators

Li-Chia Chen - Chief Investigator - University of Manchester
Claire Anderson - Collaborator - University of Nottingham
Lydia Tutt - Collaborator - University of Nottingham
Tracey Thornley - Collaborator - Boots UK

Linkages

HES Admitted Patient Care;HES Outpatient;ONS Death Registration Data;Patient Level Index of Multiple Deprivation;Practice Level Index of Multiple Deprivation