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Adherence to postmenopausal hormone therapy during the year after the initial prescription: A population-based study
D A Hill1, N S Weiss, A Z LaCroix
1Department of Epidemiology, University of Washington, Fred Hutchinson Cancer Research Center, Seattle, USA.
American Journal of Obstetrics and Gynecology
|February 29, 2000
Summary
Continuous combined hormone therapy shows better adherence than sequential therapy over one year. However, overall nonadherence rates highlight the need for improved menopausal hormone therapies for sustained patient use.
Area of Science:
- Gynecology
- Pharmacology
- Women's Health
Background:
- Randomized trials suggest continuous combined hormone replacement therapy (HRT) has higher completion rates than sequential therapy.
- Adherence to HRT in real-world, less-selected populations requires further investigation.
Purpose of the Study:
- To determine adherence rates to hormone replacement therapy in a less-selected population.
- To compare adherence between continuous combined and sequential HRT regimens.
Main Methods:
- Telephone interviews conducted 12-15 months after initiating HRT.
- Data collected on continued use, regimen switching, and discontinuation.
- Computerized pharmacy records used to verify prescription data.
Main Results:
- At one year, 68.9% of continuous combined HRT users continued their regimen versus 54.4% of sequential users.
- Continuous combined HRT users were less likely to switch regimens (10.0% vs 20.2%) or discontinue (21.2% vs 25.4%).
- Overall, continuous combined HRT showed better adherence (less switching or discontinuation) than sequential HRT (RR 0.6, 95% CI 0.4-1.0).
Conclusions:
- Continuous combined HRT demonstrates superior adherence compared to sequential HRT in a general population.
- High rates of nonadherence in both groups indicate a need for more acceptable and sustainable menopausal therapies.