Castelo-Branco Camil, Ferrer Javier, Palacios Santiago, Cornago Sonia
Hospital Clínic, University of Barcelona, Villarroel 170, 08036-Barcelona, Spain.
Maturitas. 2006 Nov 20;55(4):308-16. doi: 10.1016/j.maturitas.2006.04.023. Epub 2006 May 26.
The purpose of this study was to determine the frequency with which hormone replacement therapy (HRT) was prescribed and to identify physician-related factors associated with the prescription of HRT in Spain.
A descriptive cross-sectional survey based on a personal interview with a structured questionnaire was conducted in April 2005 with physicians aged 25-65 years. A total of 2700 doctors were asked to participate in this prospective study (1350 GY and 1350 GP). This number included 270 gynaecologists (GY group) and 270 general practitioners (GP group).
Only 10% of gynaecologists and 19.4% of GPs had never prescribed HRT. The reasons given for not prescribing HRT were adverse effects and the fear of cancer among GPs and adverse effects and social alarm in the GY group. Phytoestrogens were the most commonly used alternative; however, GPs were more willing to use antidepressants and benzodiazepines than GYs. The frequency of HRT prescription in symptomatic women was significantly higher among GYs. The main reasons for prescribing HRT were climacteric complaints and improvement in life quality for GYs and, climacteric complaints and the prevention of osteoporosis for GPs. Seventy-eight percent of GYs prescribing hormones referred a high degree of satisfaction with HRT, whereas only 50% of GPs expressed a similar attitude.
Concern for HRT prescription in Spain is high. Adverse effects and the fear of cancer are negative conditioning factors in the prescription of HRT, whereas climacteric complaints, quality of life and the prevention of osteoporosis are positive conditioning factors. GYs are more willing to use HRT than GPs. This contrast may reflect the indecision of GPs regarding the preventive value of HRT.
本研究旨在确定西班牙激素替代疗法（HRT）的处方频率，并识别与HRT处方相关的医生因素。
2005年4月，采用基于结构化问卷的个人访谈方式，对25 - 65岁的医生进行了描述性横断面调查。共邀请2700名医生参与这项前瞻性研究（1350名妇科医生和1350名全科医生）。其中包括270名妇科医生（妇科组）和270名全科医生（全科组）。
只有10%的妇科医生和19.4%的全科医生从未开过HRT处方。全科医生不开具HRT处方的原因是不良反应和对癌症的恐惧，而妇科组的原因是不良反应和社会恐慌。植物雌激素是最常用的替代药物；然而，与妇科医生相比，全科医生更愿意使用抗抑郁药和苯二氮䓬类药物。有症状女性中HRT的处方频率在妇科医生中显著更高。妇科医生开具HRT的主要原因是更年期症状和生活质量改善，而全科医生是更年期症状和预防骨质疏松。78%开具激素处方的妇科医生对HRT表示高度满意，而只有50%的全科医生表达了类似态度。
西班牙对HRT处方的关注度较高。不良反应和对癌症的恐惧是HRT处方的负面制约因素，而更年期症状、生活质量和预防骨质疏松是正面制约因素。妇科医生比全科医生更愿意使用HRT。这种差异可能反映了全科医生对HRT预防价值的犹豫不决。
