美国女性使用延长周期与每月周期复方口服避孕药的真实世界经验：国民健康与 Wellness 调查
Real-world experience of women using extended-cycle vs monthly-cycle combined oral contraception in the United States: the National Health and Wellness Survey.
作者信息
Nappi Rossella E, Lete Iñaki, Lee Lulu K, Flores Natalia M, Micheletti Marie-Christine, Tang Boxiong
机构信息
Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause, IRCCS Policlinico San Matteo Foundation, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Piazzale Golgi 2, 27100, Pavia, Italy.
Araba University Hospital, Jose Atxotegi Street, Vitoria, Spain.
出版信息
BMC Womens Health. 2018 Jan 18;18(1):22. doi: 10.1186/s12905-017-0508-6.
BACKGROUND
The real-world experience of women receiving extended-cycle combined oral contraception (COC) versus monthly-cycle COC has not been reported.
METHODS
Data were from the United States 2013 National Health and Wellness Survey. Eligible women (18-50 years old, premenopausal, without hysterectomy) currently using extended-cycle COC (3 months between periods) were compared with women using monthly-cycle COC. Treatment satisfaction (1 "extremely dissatisfied" to 7 "extremely satisfied"), adherence (8-item Morisky Medication Adherence Scale), menstrual cycle-related symptoms, health-related quality of life (HRQOL) and health state utilities (Medical Outcomes Short Form Survey-36v2®), depression (9-item Patient Health Questionnaire), sleep difficulties, Work Productivity and Activity Impairment-General Health, and healthcare resource use were assessed using one-way analyses of variance, chi-square tests, and generalized linear models (adjusted for covariates).
RESULTS
Participants included 260 (6.7%) women using extended-cycle and 3616 (93.3%) using monthly-cycle COC. Women using extended-cycle COC reported significantly higher treatment satisfaction (P = 0.001) and adherence (P = 0.04) and reduced heavy menstrual bleeding (P = 0.029). A non-significant tendency toward reduced menstrual pain (39.5% versus 47.3%) and menstrual cycle-related symptoms (40.0% versus 48.7%) was found in women using extended-cycle versus monthly-cycle COC. Significantly more women using extended-cycle COC reported health-related diagnoses, indicating preferential prescription for extended-cycle COC among women reporting more health problems. Consistent with this poorer health, more women using extended-cycle COC reported fatigue, headache, and activity impairment (P values < 0.05). There were no other significant differences between groups.
CONCLUSIONS
This real-world observational study supports extended-cycle COC as a valuable treatment option with high satisfaction, high adherence, and reduced heavy menstrual bleeding.
背景
尚未有关于接受延长周期复方口服避孕药（COC）与每月周期COC的女性的真实世界经验的报道。
方法
数据来自美国2013年国民健康与幸福调查。将目前使用延长周期COC（月经周期间隔3个月）的符合条件的女性（18 - 50岁，绝经前，未行子宫切除术）与使用每月周期COC的女性进行比较。使用方差分析、卡方检验和广义线性模型（针对协变量进行调整）评估治疗满意度（1分为“极其不满意”至7分为“极其满意”）、依从性（8项Morisky药物依从性量表）、月经周期相关症状、健康相关生活质量（HRQOL）和健康状态效用（医学结局简表调查-36v2®）、抑郁（9项患者健康问卷）、睡眠困难、工作效率和活动障碍-一般健康以及医疗资源使用情况。
结果
参与者包括260名（6.7%）使用延长周期COC的女性和3616名（93.3%）使用每月周期COC的女性。使用延长周期COC的女性报告的治疗满意度（P = 0.001）和依从性（P = 0.04）显著更高，且重度月经出血减少（P = 0.029）。在使用延长周期COC与每月周期COC的女性中，发现月经疼痛减轻（39.5%对47.3%）和月经周期相关症状减轻（40.0%对48.7%）的趋势不显著。使用延长周期COC的女性报告有健康相关诊断的明显更多，这表明在报告更多健康问题的女性中，延长周期COC的处方更具倾向性。与这种较差的健康状况一致，更多使用延长周期COC的女性报告有疲劳、头痛和活动障碍（P值<0.05）。两组之间没有其他显著差异。
结论
这项真实世界观察性研究支持延长周期COC作为一种有价值的治疗选择，具有高满意度、高依从性和减少重度月经出血的特点。
Zotero 插件