Adherence with hormone replacement therapy in menopause I. Fistonic, D. Franic*, J. Popic { , N. Fistonic { and A. Maletic { Menopause Clinic, Zagreb, Croatia; *Outpatient Ob/Gyn Clinic, Rogaska Slatina, Slovenia; { Department of Diagnostic and Interventional Radiology, Clinical Hospital Merkur, Zagreb, Croatia; { University of Zagreb Medical School, Zagreb, Croatia Key words: ADHERENCE TO THERAPY, COMPLIANCE, MENOPAUSE, SEXUALITY, HRT ABSTRACT Objective Lack of adherence to therapy is a common problem in the treatment of various diseases and conditions and there are many well-documented reasons for it. This study was conducted to assess the effect of time spent on medical consultation in relation to the duration of adherence, as well as the reasons to adhere to or drop out from hormone replacement therapy (HRT). Design and methods Two methods were used, self-filled questionnaires on a sample of patients and telephone interviews on a sample of doctors. The questions dealt with a number of personal and gynecological history variables. The participants were chosen using random sampling from population lists. A total of 74 participating offices recruited all postmenopausal patients, regardless of their HRT use and whether they visited the office for a specific complaint or just for a routine check-up. The doctors were interviewed regarding the average time spent with a patient, prescribing dilemmas and counselling on sexuality. Results The main finding was that the time spent on consultation and the physicians’ interest in postmenopause critically influence the patients’ adherence. The effective time spent with patients was in accordance with the National Health Insurance guidelines for public sector doctors, but it was twice as long for private sector doctors. Conclusion This study shows that extended medical consultation promotes better compliance by lowering patient fears, while trusted authorities seem to be more convincing to patients on the benefits of HRT and therefore more effective, even if they do not take more time to talk to patients. INTRODUCTION It is a well-established fact that hormone replacement therapy (HRT) promotes quality of life in postmeno- pause 1 . Nevertheless, there are many reasons why patients do not adhere to drug treatment. Forgetfulness is most common in low-motivated patients. Although the disease or condition itself causes concern, possible side-effects may also worry the patient, resulting in reluctance to follow the prescribed treatment schedule 2 . The term ‘compliance’ refers to the time span during which patients adhere to therapy, concerning its regular intake 3 , as indicated by the physician. A study of postmenopausal women in Croatia 4 showed not only low use of HRT (8.3%), but also a high frequency of drop-outs and a short average duration of therapy (3 months). It was shown that the patients’ attitudes, especially the negative ones, influence the frequency of drop-out. Furthermore, this study demon- strated that the specialization of the doctor recommend- ing HRT influences whether patients drop-out in the sense that the lowest adherence was found in family doctors, internists and endocrinologists, while the highest adherence was found in patients who were recommended Correspondence: Dr I. Fistonic, Ob/Gyn and Menopause Clinic, Preradoviceva 10, 10000 Zagreb, Croatia CLIMACTERIC 2010;13:570–577 ORIGINAL ARTICLE ª 2010 International Menopause Society DOI: 10.3109/13697130903491018 Received 29-03-2009 Revised 16-09-2009 Accepted 23-10-2009