International guidelines recommend adjuvant bisphosphonates (BPs) for post-menopausal women with early breast cancer to reduce recurrence and mortality. However, globally, wide variation exists in their adoption. In the UK, adjuvant BPs were a recommendation in the breast cancer Clinical Reference Group service specification and were included as a priority for implementation by the national oncologists group UK Breast Cancer Group in November 2015, promoting national uptake, guidance and funding arrangements. In 2018, adjuvant BPs were recommended by the UKs National Institute for Health and Care Excellence. In Australia, adjuvant BPs are still ‘off-label’ and do not receive national reimbursement or endorsement. To date there has been no research into the prescribing habits of these agents in Australia. With the aim to gather data on adjuvant BPs prescribing practices, online surveys were developed and disseminated to breast oncologists in both countries between December 2018 and June 2019. Almost all of the UK oncologists prescribed adjuvant BPs, demonstrating that education, endorsement from professional bodies, presence of national guidelines and funding decisions have been critical to implementation. In contrast, only 48% of the Australian responders prescribed adjuvant BPs, while 83% reported that they would prescribe them if funding was available. Lack of local protocol guidance was also seen as a major barrier. This study was intended to assess the pathway taken for adjuvant BP implementation in the UK and how it might inform changes in Australian practice and also guide other countries with similar issues with the ultimate aim of improving the care of women with early breast cancer globally.

国际指南推荐对患有早期乳腺癌的绝经后妇女使用辅助性双膦酸盐 (BPs) 以降低复发率和死亡率。然而，在全球范围内，它们的采用存在很大差异。在英国，辅助 BPs 是乳腺癌临床参考小组服务规范中的一项建议，并于 2015 年 11 月被国家肿瘤学家组织英国乳腺癌小组列为优先实施，促进了国家的采纳、指导和资金安排。2018 年，英国国家健康与护理卓越研究所推荐了辅助 BPs。在澳大利亚，佐剂 BP 仍处于“标签外”状态，无法获得国家报销或认可。迄今为止，尚未对澳大利亚这些药物的处方习惯进行研究。为了收集关于辅助 BPs 处方实践的数据，在 2018 年 12 月至 2019 年 6 月期间开发了在线调查并将其传播给了两国的乳腺肿瘤学家。国家准则和供资决定的存在对实施至关重要。相比之下，只有 48% 的澳大利亚响应者开出了辅助 BP，而 83% 的人报告说，如果有资金，他们会开处方。缺乏当地协议指导也被视为主要障碍。