Patient Compliance of Women Taking Estrogen Replacement Therapy
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0092-8615/97 Copyright 0 1997
Drug Information Association Inc.
PATIENT COMPLIANCE OF WOMEN TAKING ESTROGEN REPLACEMENT THERAPY RAYANNE S. BERMAN,PHD Temple University School of Pharmacy, Philadelphia, Pennsylvania
This was a study of the medication taking compliance of 2,106 women who were taking estrogen replacement therapy. Prescription refill information from a centralized prescription database was used to measure compliance. Patient and physician information obtained from insurance claims databases and medical records was linked to the compliance information to see if there was a set of characteristics that was related to women being compliant or noncompliant on estrogen. At six months, one yea6 and two years, 79%,62%,and 40% of the women, respectively, were still filling their prescriptions f o r estrogen. Logistic regression models indicate that women 56 years of age or older, who experienced hormone side effects, had cholesterol and pap tests, or who had a history of cancer were more likely to be noncompliant. Women with a personal or family history of cardiovascular problems or who experienced menopausal symptoms were more likely to be compliant. Key Words: Estrogen replacement therapy; Patient compliance; Survival analysis; Logistic regression modeling; Centralized prescription databases
INTRODUCTION
col than women in the test drug group(s). This can have a negative effect on the sample size and the conclusions that can be drawn from the study if the women in the control group are much less compliant than the women in the test drug group(s). More information about the compliance of women taking 'estrogen and what factors affect their compliance is needed so that clinical trials can be designed taking the problem of poor estrogen compliance into account. A few studies have been done to assess the medication taking compliance of women taking ERT. A survey study by L. Nachtigall of 220 postmenopausal women, age 43-62 years, who were private patients at New York University Medical Center and had received a prescription for estrogen, indicated that 7% of the women discontinued estrogen entirely within one year of receiving the prescription. The main reason for discontinuing the estro-
PHARMACEUTICAL COMPANIES developing drugs for the treatment and prevention of osteoporosis are conducting clinical trials using a control group of women taking estrogen replacement therapy (ERT). Very little is known about the actual medication taking compliance of women taking ERT, except that it is poor due to women not liking the side effects associated with taking ERT, such as vaginal bleeding, and fear of developing breast or endometrial cancer. Clinical trials that use estrogen therapy as their control group risk being flawed because the women in the estrogen control group are more likely to drop out of the study sooner andor not take their medication according to the protoReprint address: Dr. Rayanne Berman, 1227 Independence Way, Hatfield, PA 19440.
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