The effect of physicians' advice and recommendations on the compliance with hormone replacement therapy in the treatment of postmenopausal symptoms in Japanese women--a prospective study

Abstract

A retrospective study was performed to determine the compliance of hormone replacement therapy (HRT), the reason for discontinuation. This study comprised 477 postmenopausal women who attended the women's psychosomatic and menopause clinic between January 1991 and December 2002. For the purposes of analysis, the women were classified into two groups. In Group A (242 subjects), subjects were allowed to decide whether or not to suspend or discontinue the drug, taking their condition into account, after their symptoms were alleviated. In Group B (235 subjects), all the women were informed as to the drug's excellent effects on osteoporosis and skin tissue before HRT was started and after their symptoms were alleviated. In Group A, the percentage of women who were still on this therapy was 77.7%, 34.3%, 21.1% and 8.7% at 3, 6, 12 and 24 months respectively after the start of therapy. Alternatively, in group B, the 24-month continuation rate was more than 50%. At 36 months (47.2%) and 60 months (38.7%) continuation rates were also significantly higher than those in group A (P < 0.0001). The leading reasons in the women's decision to discontinue HRT were improvement of symptoms (68.0% and 77.8% in group A and B, respectively, p = 0.408). The incidence in the women's decision to discontinue HRT by the reason of fear of cancer was significantly higher in group A (10.8%) than in group B (2.8%) (P = 0.008). In this study, the key factor affecting HRT compliance proved to be physician's advice. This means that when HRT is administered to Japanese women with the objective of alleviating menopausal symptoms and, high compliance can be expected provided individual patients are allowed to decide for themselves when HRT should begin end.