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Factors affecting long-term adherence to hormone replacement therapy after screening for osteoporosis
S A Steel1, P Albertazzi, E M Howarth
1Centre for Metabolic Bone Disease, University of Hull, UK.
Objective:
To investigate factors likely to influence adherence to hormone replacement therapy (HRT) in women known to have low bone mass.
Study Design:
This was a prospective study of bone mineral density screening in 6282 women aged 50-54 years.
Results:
Low bone mass at either the hip or spine was found in 1462 women. The principal route of HRT delivery, transdermal or oral, as well as the presence of climacteric symptoms before starting treatment, did not influence adherence. However, adherence to HRT type was significantly superior in hysterectomized women taking unopposed estradiol (median 32 months) compared with those on sequential HRT (median 28 months; p = 0.011). Overall, a 5-year adherence to HRT of 61% was achieved.
Conclusion:
Approximately 34% of women starting HRT are likely to stop in the first 2 years of use. Following this, the discontinuation rate is low. The combination of knowledge of risk for osteoporosis and regular follow-up positively influences long-term adherence to HRT.