摘要
目的:系统评价围绝经期女性绝经激素治疗(MHT)的依从性现状及影响因素,为改善治疗效果、促进女性的健康提供参考依据.方法:计算机检索PubMed、Embase、Ovid、Web of Science、中国知网(CNKI)、万方等数据库有关围绝经期女性MHT依从性及影响因素的队列研究、病例对照研究等,检索时限为建库至2023 年9 月.采用Stata 17.0 和Revman 5.3 软件进行Meta分析.结果:共纳入15 篇文献,共计1 872 人.Meta分析结果显示,围绝经期女性MHT依从率为62.4%(95%CI:54%～70%).围绝经期女性MHT依从性与文化程度(OR =0.40,95%CI:0.27～0.57)、疾病认知(OR =0.26,95%CI:0.17～0.39)、不良反应(OR = 0.45,95%CI:0.25～0.81)、居住地(OR =0.29,95%CI:0.18～0.46)、经济状况(OR =0.52,95%CI:0.29～0.95)、婚姻状况(OR =0.13,95%CI:0.02～0.87)、家庭支持(OR =0.19,95%CI:0.12～0.31)、医保费用(OR =0.24,95%CI:0.7～0.36)、就诊条件(OR =0.20,95%CI:0.13～0.32)、医患关系(OR =0.18,95%CI:0.09～0.34)、心理状况(OR =0.26,95%CI:0.20～0.36)有关.敏感性分析结果显示,结果相对稳定.Egger's检验(P =0.773)提示,纳入的文献发表偏倚风险较低.结论:围绝经期女性MHT依从性受到文化程度、疾病认知、不良反应、婚姻状况、家庭支持、居住地、就诊条件、经济状况、医保费用、医患关系、心理状态的影响.未来医务人员应加强健康教育和宣传,给予个性化治疗方案,加强医患沟通,协调社会支持和家庭支持,保障MHT的依从性和治疗效果.
Abstract
Objective:To systematically evaluate the compliance status and influencing factors of menopausal hormone therapy(MHT)in perimenopausal women,in order to provide reference for improving treatment effectiveness and promoting women's health.Method:Computer search was conducted on PubMed,Embase,Ovid,Web of Science,CNKI,Wanfang and other databases for cohort studies and case-control studies on MHT compliance and influencing factors in perimenopausal women.The search period was from the establishment of the database to September 2023.Meta analysis was conducted using Stata 17.0 and Revman 5.3 software.Result:A total of 15 articles were included,total 1 872 people.The Meta-analysis results showed that the MHT compliance rate of perimenopausal women was 62.4%(95%CI:54%-70%),the MHT compliance of perimenopausal women was associated with educational level(OR =0.40,95%CI:0.27-0.57),disease cognition(OR =0.26,95%CI:0.17-0.39),adverse reactions(OR =0.45,95%CI:0.25-0.81),place of residence(OR =0.29,95%CI:0.18-0.46),economic status(OR =0.52,95%CI:0.29-0.95),marital status(OR =0.13,95%CI:0.02-0.87),family support(OR = 0.19,95%CI:0.12-0.31),medical insurance expenses(OR = 0.24,95%CI:0.7-0.36),medical conditions(OR =0.20,95%CI:0.13-0.32),doctor-patient relationship(OR =0.18,95%CI:0.09-0.34),and psychological status(OR =0.26,95%CI:0.20-0.36).The sensitivity analysis results show that results were relatively stable.Egger's test(P =0.773)showed a lower risk of publication bias in the included literature.Conclusion:MHT compliance rate in perimenopausal women are influenced by education level,disease cognition,adverse reactions,marital status,family support,place of residence,medical conditions,economic status,medical insurance costs,doctor-patient relationship and psychological status.In the future,medical personnel should strengthen health education and publicity,provide personalized treatment plans,strengthen doctor-patient communication,coordinate social and family support,and ensure the compliance and treatment effectiveness of MHT.
NETL
NSTL
维普
万方数据