Cline Richard R, Farley Joel F, Hansen Richard A, Schommer Jon C
College of Pharmacy, University of Minnesota, 308 Harvard St., SE, Minneapolis, MN 55455, USA.
Maturitas. 2005 Mar 14;50(3):196-208. doi: 10.1016/j.maturitas.2004.05.004.
Although a number of prescription medications are effective for the prevention and treatment of osteoporosis, little is known about the role of beliefs and attitudes in women decisions to use these drugs. The objectives of this study were (1) to assess the role of beliefs and attitudes regarding osteoporosis and prescription antiresorptive drugs in the decision to use newer antiresorptive medicines (such as bis-phosphonates, selective estrogen receptor modulators, and calcitonin nasal) and (2) to assess the role of these same beliefs and attitudes in the decision to use hormone therapy.
Data were collected using a cross-sectional survey mailed to 1700 community dwelling women age 45 and older residing in Minnesota. Respondents completed measures of health belief model constructs, medication profiles and demographics. Data were analyzed using multivariate logistic regression models.
A total of 983 usable survey forms were returned, yielding an adjusted response rate of 60.7%. More than one quarter of respondents reported using a prescription antiresorptive agent, with 90 (9.2%) currently taking a newer antiresorptive agent and 163 (16.6%) using hormone therapy. Several health belief model components were predictive of newer antiresorptive medicine use, including higher perceptions of susceptibility to osteoporosis (OR 1.34, 95% CI 1.20-1.49), perceptions of strong benefits of antiresorptive medicines (OR 1.34, 95% CI 1.10-1.63), and perceptions of few barriers to the use of antiresorptive medicines (OR 0.51, 95% CI 0.38-0.67). Several cues to action also were predictive of newer antiresorptive medicine use. Use of hormone therapy was associated with a single cue to action (being tested for osteoporosis (OR 1.74, 95% CI 1.14-2.66) and the perception of few barriers to the use of prescription antiresorptives (OR 0.65, 95% CI 0.55-0.77).
Several health belief model constructs were associated with the decision to use newer antiresorptive drugs relative to no prescription therapy. However, few model components as operationalized in this study were predictive of the use of hormone therapy. Although the health belief model appears to provide a plausible model of the decision to undertake newer antiresorptive drug therapy, it explains little about women use of hormone therapy.
尽管许多处方药对骨质疏松症的预防和治疗有效，但对于信念和态度在女性使用这些药物决策中的作用却知之甚少。本研究的目的是：（1）评估关于骨质疏松症和抗吸收处方药的信念和态度在使用新型抗吸收药物（如双膦酸盐、选择性雌激素受体调节剂和降钙素鼻喷剂）决策中的作用；（2）评估这些相同的信念和态度在使用激素疗法决策中的作用。
通过向明尼苏达州1700名年龄在45岁及以上的社区居住女性邮寄横断面调查问卷来收集数据。受访者完成了健康信念模型构建、用药情况和人口统计学指标的测量。使用多变量逻辑回归模型对数据进行分析。
共返回983份可用调查问卷，调整后的回复率为60.7%。超过四分之一的受访者报告使用过抗吸收处方药，其中90人（9.2%）目前正在使用新型抗吸收药物，163人（16.6%）使用激素疗法。健康信念模型的几个组成部分可预测新型抗吸收药物的使用，包括对骨质疏松症易感性的更高认知（比值比1.34，95%置信区间1.20 - 1.49）、对抗吸收药物强大益处的认知（比值比1.34，95%置信区间1.10 - 1.63）以及对抗吸收药物使用障碍较少的认知（比值比0.51，95%置信区间0.38 - 0.67）。几个行动线索也可预测新型抗吸收药物的使用。激素疗法的使用与一个行动线索（接受骨质疏松症检测（比值比1.74，95%置信区间1.14 - 2.66））以及对抗吸收处方药使用障碍较少的认知（比值比0.65，95%置信区间0.55 - 0.77）相关。
相对于未进行处方治疗，健康信念模型的几个构建部分与使用新型抗吸收药物的决策相关。然而，本研究中实施的模型组成部分很少能预测激素疗法的使用。尽管健康信念模型似乎为采用新型抗吸收药物治疗的决策提供了一个合理的模型，但它对女性使用激素疗法的解释很少。
