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绝经激素治疗中断的原因调查及影响因素分析

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目的 调查更年期综合征患者中断绝经激素治疗的原因,并分析可能导致治疗中断的影响因素。方法 回顾性选择2022年3月-2023年11月在我院更年期医药联合门诊就诊并建立更年期保健手册的患者,通过手册登记的病史资料和门诊病历系统收集其病例资料。电话随访已接受绝经激素治疗的患者,了解其是否在用药并统计治疗中断的原因。采用单因素分析和多因素Logistic回归分析评价更年期综合征患者中断绝经激素治疗的影响因素。结果 纳入183例使用绝经激素治疗的患者,根据其是否中断治疗分为中断组(78例)和继续治疗组(105例)。电话随访结果显示,中断的原因主要有自觉无效(16。67%)、担心用药风险(15。38%)、存在慎用情况(12。82%)及发生不良反应(10。26%)。单因素分析结果显示,两组患者的职业、有无并发症、用药方案和骨质、血黏度是否正常比较,差异均有统计学意义(P<0。05)。多因素Logistic回归分析结果显示,无并发症、骨质减少及疏松、事业单位工作及退休、使用连续序贯用药方案使患者倾向选择继续进行绝经激素治疗(P<0。05)。结论 绝经激素治疗中断率较高,自觉无效、担心用药风险、存在慎用情况和发生不良反应对患者影响较大。存在并发症会导致患者中断绝经激素治疗,而骨质减少及疏松、事业单位工作及退休、使用连续序贯用药方案的患者则更倾向于选择继续进行绝经激素治疗。
Investigation of the causes and analysis of influencing factors about interruption of menopausal hormone therapy
OBJECTIVE To investigate the reasons for interrupting menopausal hormone therapy in patients with menopausal syndrome and analyze the influencing factors that may lead to treatment interruption.METHODS The patients who visited our menopause medicine clinic from March 2022 to November 2023 and established a menopausal health manual were collected retrospectively.The case data were collected through the medical history registered in the manual and the outpatient medical record system.Telephone follow-up was conducted among the patients who had received menopausal hormone therapy to know about whether they were taking medication and to record the reasons for treatment interruption.Univariate analysis and multivariate Logistic regression analysis were adopted to investigate the influencing factors of discontinuing menopausal hormone therapy in patients with menopausal syndrome.RESULTS A total of 183 patients receiving menopause hormone therapy were enrolled.They were divided into interruption group(78 cases)and continuation group(105 cases)according to whether the treatment was interrupted.The results of telephone follow-up showed that the reasons in turn for interruption were perceiving ineffectiveness(16.67%),concerning about medication risk(15.38%),the existence of caution case(12.82%)and adverse reactions(10.26%).The results of univariate analysis showed that there were statistically significant differences in occupation,complications,medication regimen,bone condition and blood viscosity between the two groups(P<0.05).Multivariate Logistic regression analysis showed that the absence of complications,osteopenia and osteoporosis,working in public institution and retirement,and the continuous sequential medication regimen favored continuation of menopausal hormone therapy(P<0.05).CONCLUSIONS The interruption rate of menopausal hormone therapy is relatively high,and patients are greatly affected by perceiving ineffectiveness and concerning about medication risks,the existence of caution case,and adverse reactions.Complications can cause patients to interrupt treatment,while factors such as osteopenia and osteoporosis,working in public institutions and retirement,and continuous sequential medication regimens make patients more inclined to choose to continue menopausal hormone therapy.

menopausal syndromemenopausal hormone therapyinterruption of treatmentinfluencing factors

周婷、彭雪瑶、詹侠、鲍红荣

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杭州市临安区第一人民医院药剂科,杭州 311300

更年期综合征 绝经激素治疗 治疗中断 影响因素

杭州市临安区农业与社会发展科研引导项目

临科字[2023]6号

2024

中国药房
中国医院协会,中国药房杂志社

中国药房

CSTPCD北大核心
影响因子:0.956
ISSN:1001-0408
年,卷(期):2024.35(19)