Moro Doris, Young Wendy, Stein Richard, Isaac Winston, Goodman Deborah
Ryerson University, Toronto, Ontario, Canada.
Int J Pharm Compd. 2010 Mar-Apr;14(2):165-9.
The objective of this exploratory qualitative study was to describe (1) the key factors affecting women's initial decision to explore the use of bioidentical hormone, (2) where women gather their information on bioidentical hormones, (3) the enablers and barriers to obtaining bioidentical hormones, and (4) how to improve the bioidentical hormone replacement therapy access path. The study was conducted in a compounding pharmacy located in a large urban area in southern Ontario, Canada. The participants included four postmenopausal women between the ages of 46 and 72 who self-identified as users of bioidentical hormone replacement therapy and with comprehensive provincial healthcare coverage. Participants were recruited at a compounding pharmacy with the use of tri-fold brochures, tear-sheets, and posters. The women participated in an audio-taped mini focus group. Discussion was guided by six open-ended questions. Verbatim quotes were analyzed using an affinity diagram. Participants identified three key factors related to their initial decision: (1) symptoms unalleviated by synthetic hormone replacement therapy, (2) side effects from synthetic hormone replacement therapy, and (3) personal preference. They obtained information and support from many sources, including: family/friends, publications, and specialists in menopausal health. Once participants had made a decision, they obtained a prescription and accessed bioidentical hormone replacement therapy at a compounding pharmacy. Knowledgeable primary care physicians and compounding pharmacists were seen as enablers. Lack of support/Information and costs were identifies as barriers. Improvements to bioidentical hormone replacement therapy access path were suggested. The results of this study suggest that there may be value in implementing strategies to further encourage family physicians and other specialists in menopausal health to discuss options regarding hormone replacement therapy with patients. For example, the preparation and distribution of updated consumer decision aids that summarize the evidence on the options regarding hormone replacement therapy, including bioidentical hormone replacement therapy, could be considered.
（1）影响女性初次决定探索使用生物同源激素的关键因素；（2）女性获取生物同源激素信息的途径；（3）获取生物同源激素的促进因素和障碍；（4）如何改善生物同源激素替代疗法的获取途径。该研究在加拿大安大略省南部一个大城市的一家配制药房进行。参与者包括四名年龄在46至72岁之间的绝经后女性，她们自我认定为生物同源激素替代疗法的使用者，并享有全面的省级医疗保健覆盖。参与者是在一家配制药房通过使用三折式宣传册、单页宣传资料和海报招募的。这些女性参加了一个录音迷你焦点小组。讨论由六个开放式问题引导。逐字引用的内容使用亲和图进行分析。参与者确定了与她们初次决定相关的三个关键因素：（1）合成激素替代疗法无法缓解的症状；（2）合成激素替代疗法的副作用；（3）个人偏好。她们从许多来源获得信息和支持，包括：家人/朋友、出版物以及绝经健康专家。一旦参与者做出决定，她们就会获得处方，并在配制药房获取生物同源激素替代疗法。知识渊博的初级保健医生和配制药剂师被视为促进因素。缺乏支持/信息和费用被确定为障碍。有人提出了改善生物同源激素替代疗法获取途径的建议。这项研究的结果表明，实施策略以进一步鼓励家庭医生和其他绝经健康专家与患者讨论激素替代疗法的选择可能具有价值。例如，可以考虑编写和分发更新的消费者决策辅助工具，总结包括生物同源激素替代疗法在内的激素替代疗法选择的证据。
