engleski

Adherence with hormone replacement therapy in menopause

Lack of adherence to therapy is a common problem in the treatment of various diseases and conditions and there are many well documented reasons for it. Although patients are generally motivated to adhere to therapy by their concern regarding the disease itself, possible side effects may also worry the patient, resulting in reluctance to follow the treatment plan. The patients’ adherence to HRT was shown to be dependent on the specialisation/position of the physician who initially recommended it, the adherence rate being highest at private gynaecologists' and university clinics and lowest at general practice and community health centres. Adherence to HRT in Croatia was found to be exceptionally low. This study was conducted to assess the effect of time spent on medical consultation in relation to the duration of adherence, as well as the reasons to adhere to or drop out from HRT. Two methods were used, self-filled questionnaires on a sample of patients and telephone interviews on a sample of doctors. The patient questionnaires were administered and collected at the Ob/Gyn and GP offices. The questions dealt with a number of personal and gynaecological history variables, including use of HRT, origination of HRT recommendation, attitudes in favour and against HRT, and total duration of HRT. A total of 40 participating offices submitted 1, 263 patient questionnaires for analysis. The doctors' attitudes and time spent on consultation were assessed using telephone interviews on a sample of 90 gynaecologists employed by clinical hospitals, health community centres and private practices. The doctors were interviewed regarding the average time spent with a patient, dilemmas in prescribing HRT and counselling on sexuality issues. The main finding was that the time spent on consultation and the physicians' interest in postmenopause critically influence the patients' adherence. The effective time spent with patients was in accordance with the National Health Insurance guidelines for public sector doctors, but it was twice as long for private sector doctors, who can also boast of the highest adherence rates. This study shows that extended medical consultation promotes better compliance through lowering patient fears, while trusted authorities seem to be more convincing to patients on the benefits of HRT and therefore more effective, even if not taking more time to talk to patients.

adherence to therapy ; compliance ; menopause ; sexuality ; HRT

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