Physician–patient alignment on menopause-associated symptom burden: real-world evidence from the USA and Europe

This study aimed to evaluate physician–patient alignment on menopausal symptom burden and impact for women experiencing natural vasomotor symptoms (nVMS) or VMS induced by endocrine therapy for breast cancer (iVMS). For this real-world, cross-sectional survey, physicians from the USA and five European countries provided data for consulting patients experiencing nVMS/iVMS; patients optionally self-reported their experiences. Alignment between physician and patient responses was assessed using weighted Cohen’s <i>κ</i> analysis. Physicians and patients completed 1029 pairs of surveys (846 nVMS; 183 iVMS). In 28.1% of cases for nVMS and 29.6% for iVMS, patients reported more severe vasomotor symptoms (VMS) than physicians; alignment of responses was slight (nVMS, <i>κ</i> = 0.1364, <i>p</i> ≤ 0.0001; iVMS, <i>κ</i> = 0.1014, <i>p</i> = 0.039). For the non-VMS symptoms surveyed, 18.5–34.9% of patients with nVMS and iVMS reported symptoms without a corresponding physician report; sleep disturbances, cognitive difficulties and mood changes were among the symptoms most under-reported by physicians. Alignment regarding the impact of nVMS and iVMS on sleep, mood and overall quality of life was moderate. Only slight to moderate physician–patient alignment was found across all areas surveyed. These findings suggest that physicians often underestimate the severity of VMS and the presence of other menopausal symptoms, highlighting a need to improve physician–patient communication.本研究旨在评估出现自然血管舒缩症状（natural vasomotor symptoms，nVMS）或乳腺癌内分泌治疗诱导的血管舒缩症状（induced vasomotor symptoms，iVMS）的女性群体中，医患双方对其绝经症状负担及影响的一致性水平。本项真实世界横断面调查中，来自美国及五个欧洲国家的医师为就诊的nVMS/iVMS患者提供相关评估数据；患者可自愿自述自身症状体验。研究采用加权科恩κ（weighted Cohen’s κ）分析，对医患双方的应答一致性进行评估。本次调查共回收1029组有效配对问卷，其中自然血管舒缩症状组846份，诱导性血管舒缩症状组183份。在自然血管舒缩症状亚组中28.1%的病例、诱导性血管舒缩症状亚组中29.6%的病例中，患者自述的血管舒缩症状（vasomotor symptoms，VMS）严重程度高于医师评估结果；双方应答的一致性程度较低（自然血管舒缩症状组：κ=0.1364，p≤0.0001；诱导性血管舒缩症状组：κ=0.1014，p=0.039）。针对本次调查涵盖的非血管舒缩症状，自然血管舒缩症状与诱导性血管舒缩症状患者中分别有18.5%~34.9%的人群自述存在相关症状，但医师未在评估中予以记录；睡眠障碍、认知困难及情绪改变是医师最易漏报的症状类型之一。针对自然血管舒缩症状与诱导性血管舒缩症状对睡眠、情绪及整体生活质量的影响，医患双方的应答一致性程度为中等。本次所有调查领域的评估结果均显示，医患间仅存在轻度至中等程度的一致性。上述研究结果表明，医师往往低估了血管舒缩症状的严重程度及其他绝经症状的存在，凸显了改善医患沟通的必要性。