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西班牙的医生与激素替代疗法的处方

Physicians and the prescription of hormone replacement therapy in Spain.

作者信息

Bermejo María José, Pérez Isabel Ruiz

机构信息

Department of Preventive Medicine, Hospital Universitario Virgen de las Nieves, Granada, Spain.

出版信息

Health Policy. 2005 Jul;73(1):58-65. doi: 10.1016/j.healthpol.2004.10.001. Epub 2004 Nov 18.

Abstract

OBJECTIVES

The purpose of this study was to determine the frequency of hormone replacement therapy (HRT) prescription and identify women's sociodemographic and climacteric factors, as well as variables related to healthcare, associated with the treatment's prescription in women aged 45-65 years in the reference population of a primary healthcare centre in the city of Granada (Spain).

METHODS

A descriptive cross-sectional telephone survey was conducted in July 2002 with women aged 45-65 years from the reference population of a primary healthcare centre. The information was gathered using a semi-structured questionnaire specifically developed to gather information on the prescription of HRT.

RESULTS

22.3% of the sample had ever been prescribed with HRT. Regarding compliance with the treatment, 44.2% of the women prescribed with this therapy took it partially, and 8.1% did not begin with the treatment. The variables independently associated with HRT prescription were having the menopause (OR=2.81; IC 95%: 1.08-7.28), having psychological symptoms (OR=2.77; IC 95%: 1.19-6.46), going to see the gynaecologist (OR=4.41; IC 95%: 1.87-10.36), and the fact that the doctor worked in the private healthcare sector (OR=3.55; IC 95%: 0.92-13.65).

CONCLUSIONS

The frequency of HRT prescription in Spain is high, as well as the non-compliance rate. Reaching the menopause and going to the gynaecologist are determinant in HRT prescription. It would be desirable to use similar methodological approaches in studies of this controversial therapy, in order to obtain consensus on the real impact on the female population, particularly in view of the results of the latest clinical trials.

摘要

目的

本研究旨在确定激素替代疗法(HRT)的处方频率,并识别45至65岁女性的社会人口统计学和更年期因素,以及与医疗保健相关的变量,这些变量与西班牙格拉纳达市一家初级医疗中心参考人群中女性的该治疗处方相关。

方法

2002年7月,对一家初级医疗中心参考人群中45至65岁的女性进行了描述性横断面电话调查。使用专门设计的半结构化问卷收集信息,以获取有关HRT处方的信息。

结果

22.3%的样本曾接受过HRT处方。关于治疗依从性,接受该疗法处方的女性中有44.2%部分服用,8.1%未开始治疗。与HRT处方独立相关的变量有处于更年期(OR = 2.81;95%置信区间:1.08 - 7.28)、有心理症状(OR = 2.77;95%置信区间:1.19 - 6.46)、看妇科医生(OR = 4.41;95%置信区间:1.87 - 10.36),以及医生在私立医疗部门工作这一事实(OR = 3.55;95%置信区间:0.92 - 13.65)。

结论

西班牙HRT处方频率较高,不依从率也较高。进入更年期和看妇科医生是HRT处方的决定因素。在这项有争议的疗法研究中,采用类似的方法很有必要,以便就其对女性人群的实际影响达成共识,特别是鉴于最新临床试验的结果。

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