Compliance with hormone replacement therapy (HRT) after screening for post menopausal osteoporosis.
OBJECTIVE
To assess compliance with recommendations for hormone replacement therapy (HRT) in postmenopausal women following screening for osteoporosis.


METHODS
A postal questionnaire sent to women an average of 8 months (range 6-12) following measurement of their bone mineral density (BMD), and recommendations regarding HRT given to the referring general practitioner.


METHODS
Referrals from local general practitioners. Mixed social class.


METHODS
400 postmenopausal women aged 40-69 years (average age 52).


METHODS
Compliance with advice and if failing to comply, reasons for not doing so.


RESULTS
Replies were received from 352 women (88%) and 74% of respondents followed advice to start, continue, or refrain from starting or continuing HRT with regard to protecting their skeleton. Those who rejected advice to take HRT mostly had concern over side effects or the efficacy or safety of treatment. Of the women who started HRT 28% subsequently stopped, the principal reasons being withdrawal bleeding and weight gain. Of the women recommended to take HRT, 39% were not taking treatment by 8 months after referral, either because they ignored advice given (22%) or because of side effects (17%).


CONCLUSIONS
Screening leads to increased usage of HRT among women at most risk for osteoporosis. However, almost 40% of women with low bone mineral density were not taking HRT 8 months after referral, and therefore until improved compliance has been demonstrated screening cannot be widely recommended.
Ryan
P J
PJ
Department of Nuclear Medicine, Guy's Hospital, London, UK.
Harrison
R
R
Blake
G M
GM
Fogelman
I
I
D000368:Aged; D015519:Bone Density; D015914:Estrogen Replacement Therapy / Q000523:psychology / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008403:Mass Screening; D008875:Middle Aged; D010024:Osteoporosis / Q000175:diagnosis / Q000517:prevention & control*; D010349:Patient Compliance; D013997:Time Factors