title: Results of a community pharmacy-based breast cancer risk-assessment and education program.
abstract: We tested the hypothesis that an education program addressing breast cancer screening schedules and modalities coupled with a breast cancer risk assessment provided by community pharmacists can increase women's confidence in performing screening practices endorsed by the American Cancer Society (ACS). This randomized, paired, pre-post study was conducted in six community pharmacies and two health-screening fairs; subjects were 140 women over 18 years of age. The pharmacist-administered program used the Breast Cancer Risk-Assessment Tool (Gail model) software provided by the National Cancer Institute of the National Institutes of Health. In addition, pharmacists provided education and training on breast self-examination (BSE), clinical breast examination (CBE), and mammography. Adherence to ACS guidelines for monthly BSE increased from 31% to 56% (p<0.001) for all women 6 months after the program. Performance of monthly BSE by women considered at high risk for developing breast cancer increased from 20% to 60% (p<0.005). The mean number of BSEs performed over 6 months increased from 2.69 to 4.09 (p<0.001). Women's confidence performing correct BSE improved from 6.41 to 7.04 (p<0.001) on a scale of 0-10. Adherence to ACS guidelines for CBE and mammography did not reveal statistically significant improvements except for better adherence to CBE in women aged 40-49 years (81% to 97%, p<0.025). The strength of the pharmacists' intervention may not appear as manipulation of high-risk patients' behavior but as improvement of self-directed behaviors, such as BSE, across all age groups.
authors.affiliation: School of Pharmacy, Virginia Commonwealth University, Medical College of Virginia Campus, Richmond 23298-0533, USA.
authors.forename: J T
authors.initials: JT
authors.lastname: Giles
authors.forename: D T
authors.initials: DT
authors.lastname: Kennedy
authors.forename: E C
authors.initials: EC
authors.lastname: Dunn
authors.forename: W L
authors.initials: WL
authors.lastname: Wallace
authors.forename: S L
authors.initials: SL
authors.lastname: Meadows
authors.forename: A C
authors.initials: AC
authors.lastname: Cafiero
mesh_terms: D000293:Adolescent; D000328:Adult; D001943:Breast Neoplasms / Q000175:diagnosis / Q000517:prevention & control; D016504:Breast Self-Examination / Q000379:methods; D003157:Community Pharmacy Services / Q000458:organization & administration*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods*; D010595:Pharmacists; D018570:Risk Assessment; D018709:Statistics, Nonparametric