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Adherence with hormone replacement therapy in menopause

Objective Lack of adherence to therapy is a common problem in the treatment of various diseases and conditions and there are many well-documented reasons for it. This study was conducted to assess the effect of time spent on medical consultation in relation to the duration of adherence, as well as the reasons to adhere to or drop out from hormone replacement therapy (HRT). Design and methods Two methods were used, self-filled questionnaires on a sample of patients and telephone interviews on a sample of doctors. The questions dealt with a number of personal and gynecological history variables. The participants were chosen using random sampling from population lists. A total of 74 participating offices recruited all postmenopausal patients, regardless of their HRT use and whether they visited the office for a specific complaint or just for a routine check-up. The doctors were interviewed regarding the average time spent with a patient, prescribing dilemmas and counselling on sexuality. Results The main finding was that the time spent on consultation and the physicians' interest in postmenopause critically influence the patients' adherence. The effective time spent with patients was in accordance with the National Health Insurance guidelines for public sector doctors, but it was twice as long for private sector doctors. Conclusion This study shows that extended medical consultation promotes better compliance by lowering patient fears, while trusted authorities seem to be more convincing to patients on the benefits of HRT and therefore more effective, even if they do not take more time to talk to patients.