Women's concerns with hormone replacement therapy--compliance issues.
OBJECTIVE
To review the literature and attempt to define patient compliance with hormonal replacement therapy and physician prescription of these therapies.


METHODS
Review of selected literature.


METHODS
Population studies and clinical trials.


METHODS
Postmenopausal and postcastration women.


METHODS
Hormone replacement regimens.


METHODS
Descriptions and compliance by patients.


RESULTS
In addition to the effective control of vasomotor hot flushes and atrophic genital changes in postmenopausal women, it is now well established that the long-term use of estrogen replacement therapy (ERT) or hormone replacement therapy (HRT) with estrogen and/or progestin offers prophylaxis against osteoporosis and cardiovascular arteriosclerotic disease, notably myocardial infarction. However, despite such documentation of benefit, it is estimated that < 20% of postmenopausal women in the United States have ever had ERT or HRT prescribed, < 40% of those for whom such treatment has been prescribed will continue it after 1 year, and that overall, > 70% of those for whom it has been prescribed are not compliant. It appears that this lack of prescription and compliance are the function of both physician and patient considerations. This paper presents reasons for such actions and reviews ways in which use can be improved.
Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina 27710.
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Hammond
D015914:Estrogen Replacement Therapy; D005260:Female; D006801:Humans; D010349:Patient Compliance; D010818:Practice Patterns, Physicians'; D016387:Women's Health