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Journal of the Korean Academy of Family Medicine 2003;24(4):353-359.
Published online April 10, 2003.
Factors Related to the Compliance of Hormone Replacement Therapy for Menopausal Women.
Kyeong Ho Park, Eun Suk Jun, Hwansik Hwang, Hoonki Park, Jung Kwon Lee
1Department of Family Medicine, Hanyang University College of Medicine, Korea. jwonl@smc.samsung.co.kr
2Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
폐경기 여성의 호르몬 보충요법 순응도의 결정요인
: Hormone replacement therapy (HRT) is the most effective treatment for climacteric symptoms. It also has definitive role in reducing or preventing the risk of osteoporosis. However, compliance with HRT is very poor. This study was conducted to know the compliance of hormone replacement therapy and investigate the determining factors for compliance.

Methods : Review of charts and telephone questionnaires were completed among 107 women who had received HRT in a family medicine clinic at a university hospital. Compliance was determined by the medication availability ratio (MAR): (HRT treated days)/(total number of observed days). An individual with MAR less than 0.75 was considered as partial compliance, and more than 0.75 was considered as complete compliance group.

Results : The average age of 107 subjects was 57.4 years. Among the 107 study subjects, 59 persons (55.1%) were compliant with HRT. Mean observation period was 17.6 months. The compliance with HRT was 60.9%, 55.1%, 49.6% at 12, 24, 36 months, respectively. The compliance was higher in high-perception group compared to low- perception group (P=0.01). Education level, presence of osteoporosis, hysterectomised state, difference in doctor and past fracture history were not associated with compliance. The reasons for starting HRT were physician's recommendation, osteoporosis prevention, treatment of menopausal symptoms, and influence of mass media, in descending order.

Conclusion : The compliance with HRT was 61% at one- year treatment and 50% at three-year teatment period. Positive attitude for HRT was related to higher compliance with HRT. Patient education on HRT is essential for successful compliance of HRT.
Key Words: hormone replacement therapy, compliance, attitudes
연구배경 : 본 연구는 호르몬 보충요법에 대한 환자의 순응도를 알아보고 순응도를 결정하는 요인을 알아보고자 시행되었다.

방법 : 대학병원 가정의학과 외래에서 호르몬보충요법을 받았던 여성 107명을 대상으로 의무기록 검토와 전화설문을 통해 순응도 및 순응도 관련요인에 대한 정보를 얻었다. 전화설문 시점에서 현재 여성호르몬을 복용중인 사람을 순응군으로 정의했고, 관찰기간 동안의 처방일수를 총 관찰기간 일수로 나눈 값이 0.75 이상이면 완전 순응군, 0.75 미만이면 불완전 순응군으로 정의하였다.

결과 : 관찰 대상 107명의 연령은 평균 57.4세였다. 전체 107명 중 59명이 순응군에 속했으며 순응률은 55.1%이었으며 완전순응군은 49명(45.8%)이고, 불완전 순응군은 10명(9.3%)이었다. 관찰 기간은 평균 17.6개월(범위; 1.0∼74.2개월)이었다. 호르몬보충요법에 대한 순응도는 12개월째, 60.9%, 24개월, 55.1%, 36개월, 49.6%였다. 호르몬 치료에 대한 인식도가 높은 군에서 인식도가 낮은 군에 비하여 순응도가 높았다(P=0.01). 교육수준, 골다공증 유무, 자궁적출술 시행여부, 주치의 차이, 골절경험 유무는 순응도와 연관성이 없었다. 호르몬 치료를 받게 된 동기는 '의사의 권유로'가 38명, '골다공증 예방에 좋다고 해서'가 31명, '갱년기 증세가 있어서'가 27명이었고 '매스컴의 영향으로'는 2명이었다.

결론 : 호르몬 보충요법의 1년 순응도는 61%, 3년 순응도는 50%였다. 여성 호르몬 치료에 대한 인식도가 높을수록 호르몬 보충요법에 대한 순응도가 높았다.
중심 단어: 호르몬 보충요법, 순응도, 인식도


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