Analysis of treatment satisfaction in patients with premature ovarian failure
- Authors: Averkova V.G.1, Yureneva S.V.1
-
Affiliations:
- Academician V.I. Kulakov National Medical Research Centre for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia
- Issue: No 10 (2022)
- Pages: 83-92
- Section: Articles
- URL: https://journals.eco-vector.com/0300-9092/article/view/249539
- DOI: https://doi.org/10.18565/aig.2022.10.83-92
- ID: 249539
Cite item
Open Access
Access granted
Abstract
Objective: To analyze treatment satisfaction in patients with premature ovarian failure (POF) and to study the frequency and severity of symptoms of estrogen deficiency in patients with POF taking hormone replacement therapy (HRT). Materials and methods: A cross-sectional study which was carried out on the basis of the National Medical Research Center for Obstetrics, Gynecology and Perinatology, included 223 patients diagnosed with POF. Treatment satisfaction was assessed using a structured survey; the severity of estrogen deficiency symptoms was determined using a questionnaire (Greene Climacteric Scale). Results: Most of the study participants (86.3%) received HRT medications containing a standard dose of estradiol (E2): 2 mg were administered orally and 1 mg of 1% gel was administered via the transdermal route. Low-dose HRT was taken by 2.2%, combined oral contraceptives (COC) were received by 1.8%. Higher doses of E2 were taken by 2.2% of the participants. The survey of the women showed that 53.8% were satisfied and 41.3% were not satisfied with the therapy. The lowest indicators of treatment satisfaction were obtained by patients who took low-dose HRT (p=0.022) and COC (p=0.048). The patients who took higher doses of E2 as part of HRT were satisfied with the treatment in 100% of cases. The average severity of climacteric syndrome among the participants was 12 points according to the Greene Climacteric Scale. The ROC analysis of the dependence of the negative assessment of therapy on the total score on the Greene Scale showed that the area under the ROC curve was 0.809 (0.031) with 95% CI: 0.748- 0.870 (p <0.001). The threshold value of the total score on the Greene Scale at the cut-off point was 14 points; the cut-off point corresponded to the highest value of the Yuden index. Conclusion: The high percentage of patients dissatisfied with therapy as well as persistent symptoms of estrogen deficiency associated with HRT administration indicate the need to revise approaches to the management of patients with POF.
Full Text
About the authors
Victoria G. Averkova
Academician V.I. Kulakov National Medical Research Centre for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia
Email: buchl202@mail.ru
PhD. student at the Department of Gynecological Endocrinology
Svetlana V. Yureneva
Academician V.I. Kulakov National Medical Research Centre for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia
Email: syureneva@gmail.com
Dr. Med. Sci., Professor at the Department of Obstetrics and Gynecology of the Department of Vocational Education, Deputy Director for Science, Institute of Oncology and Mammology
References
- Табеева Г. И., Шамилова Н.Н., Жахур Н.А., Позднякова А. А. Марченко Л.А. Преждевременная недостаточность яичников - загадка XXI века. Акушерство и гинекология. 2013; 12: 16-21.
- Panay N., Anderson R.A., Nappi R.E., Vincent A.J., Vujovic S., Webber L., Wolfman W. Premature ovarian insufficiency: an International Menopause Society White Paper. Climacteric. 2020; 23(5): 426-46. https://dx.doi.org/10.1080/13697137.2020.1804547.
- Torrealday S., Kodaman P., Pal L. Premature ovarian insufficiency - an update on recent advances in understanding and management. F1000Res. 2017; 6: 2069. https://dx.doi.org/10.12688/f1000research.11948.1.
- Alls house A. A., Semple A.L., Santoro N.F. Evidence for prolonged and unique amenorrhea-related symptoms in women with premature ovarian failure/primary ovarian insufficiency. Menopause. 2015; 22(2): 166-74. https://dx.doi.org/10.1097/GME.0000000000000286.
- Li X.T., Li P.Y., Liu Y., Yang H.S., He L.Y., Fang Y.G. et al. Health-related quality-of-life among patients with premature ovarian insufficiency: a systematic review and meta-analysis. Qual. Life Res. 2020; 29(1): 19-36. https://dx.doi.org/10.1007/s11136-019-02326-2.
- Gibson-Helm M., Teede H., Vincent A. Symptoms, health behavior and understanding of menopause therapy in women with premature menopause. Climacteric. 2014; 17(6): 666-73. https://dx.doi.org/10.3109/13697137.2014.913284.
- Baber R.J., Panay N., Fenton A., IMS Writing Group. 2016 IMS Recommendations on women's midlife health and menopause hormone therapy. Climacteric. 2016; 19(2): 109-50. https://dx.doi.org/10.3109/13697137.2015.1129166.
- Shikiar R., Rentz A.M. Satisfaction with medication: an overview of conceptual, methodologic, and regulatory issues. Value Health. 2004; 7(2): 204-5. https://dx.doi.org/10.1111/j.1524-4733.2004.72252.x.
- Hipp H.S., Charen K.H., Spencer J.B., Alien E.G., Sherman S.L. Reproductive and gynecologic care of women with fragile X. primary ovarian insufficiency (FXPOI). Menopause. 2016; 23(9): 993-9. https://dx.doi.org/10.1097/GME.0000000000000658.
- Российское общество акушеров-гинекологов. Менопауза и климактерическое состояние у женщины. Клинические рекомендации. М.: 2021. 86c.
- Webber L., Davies M., Anderson R., Bartlett J., Braat D., Cartwright B. et al.; European Society for Human Reproduction and Embryology (ESHRE) Guideline Group on POI. ESHRE Guideline: management of women with premature ovarian insufficiency. Hum. Reprod. 2016; 31(5): 926-37. https://dx.doi.org/10.1093/humrep/dew027.
- Greene J.G. Constructing a standard climacteric scale. Maturitas. 1998; 29(1): 25-31. https://dx.doi.org/10.1016/s0378-5122(98)00025-5.
- Green S.M., Donegan E., McCabe R.E., Fedorkow D.M., Streiner D.L., Frey B.N. Objective and subjective vasomotor symptom outcomes in the CBT-Meno randomized controlled trial. Climacteric. 2020; 23(5): 482-8. https://dx.doi.org/10.1080/13697137.2020.1737929.
- Travers C., O’Neill S.M., King R., Battistutta D., Khoo S.K. Greene Climacteric Scale: norms in an Australian population in relation to age and menopausal status. Climacteric. 2005; 8(1): 56-62. https://dx.doi.org/10.1080/13697130400013443.
- Singer D., Mann E., Hunter M.S., Pitkin J., Panay N. The silent grief: psychosocial aspects of premature ovarian failure. Climacteric. 2011; 14(4): 428-37. https://dx.doi.org/10.3109/13697137.2011.571320.
- Mann E., Singer D., Pitkin J., Panay N., Hunter M.S. Psychosocial adjustment in women with premature menopause: a cross-sectional survey. Climacteric. 2012; 15(5): 481-9. https://dx.doi.org/10.3109/13697137.2011.647841.
- Groff A.A., Covington S.N., Halverson L.R., Fitzgerald O.R., Vanderhoof V., Calis K., Nelson L.M. Assessing the emotional needs of women with spontaneous premature ovarian failure. Fertil. Steril. 2005; 83(6): 1734-41. https://dx.doi.org/10.1016/j.fertnstert.2004.11.067.
- Morgan M.W., Salzman J.G., LeFevere R.C., Thomas A.J., Isenberger K.M. Demographic, оperational, and нealthcare utilization factors associated with emergency department patient satisfaction. West J. Emerg. Med. 2015; 16(4): 516-26. https://dx.doi.org/10.5811/west-jem.2015.4.25074.
- Ku J.H., Danve A., Panq H., Choi D., Rosenbaum J.T. Determinants of рatient satisfaction in an academic rheumatology practice. J. Clin. Rheumatol. 2015; 21(5): 256-62. https://dx.doi.org/10.1097/RHU.0000000000000263.
- Webber L., Anderson R.A., Davies M., Janse F., Vermeulen N. HRT for women with premature ovarian insufficiency: a comprehensive review. Hum. Reprod. Open. 2017; 2017(2): hox007. https://dx.doi.org/10.1093/hropen/hox007.
- Sullivan S.D., Sarrel P.M., Nelson L.M. Hormone replacement therapy in young women with primary ovarian insufficiency and early menopause. Fertil. Steril. 2016; 106(7): 1588-99. https://dx.doi.org/10.1016/j.fertnstert.2016.09.046.
Supplementary files
