Factors Related to the Compliance of Hormone Replacement Therapy for Menopausal Women

BACKGROUND: 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.

The Agreement of Checklist Recordings Between Faculties and Standardized Patients in an Objective Structured Clinical Examination (OSCE) / 한국의학교육

PURPOSE: A high degree of agreement between standardized patients (SP) check-list recordings and those of faculty will be necessary if SPs are to eventually replace faculties in the OSCE evaluaton process. This study was conducted to know to what degree SPs' checklist recordings agree with those of faculties during an OSCE. METHODS: One hundred and twenty one fourth-year medical students of Hanyang University College of Medicine took an OSCE. In each of two study stations, a student saw an SP for four minutes and the SP recorded the same checklists as a faculty examiner did, for the following fifty seconds. RESULTS: For the 'bad news delivery' station, SP evaluations were more lenient compared to those of faculties (56 vs 45, p< 0.01), but in the case of 'chest pain', there was no significant difference. Pearson correlation coefficients for the 'bad news delivery' station and for the 'chest pain' case were 0.60 and 0.65, respectively. The mean percentages of agreement for the 'bad news delivery' and the 'chest pain' checklists were 71% and 82%, respectively. The mean kappa statistics for the 'bad news delivery' and the 'chest pain' check-lists were 0.19 and 0.49, respectively. CONCLUSION: The ratings by SPs were found to be consistent with those of faculties only in moderate degree. The exactness of scoring criteria, and the optimal SP training are to be the premise for the replacement of faculties by SPs during OSCE checklist recordings.