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Persistence with estrogen therapy in a postmenopausal Medicaid population
J A Kotzan1, B C Martin, W E Wade
1Clinical and Administrative Sciences, College of Pharmacy, University of Georgia, Athens 30602, USA.
Pharmacotherapy
|April 30, 1999
Summary
Estrogen replacement therapy persistence was evaluated in postmenopausal women. White women showed higher compliance rates than black women, with younger, white individuals most likely to continue therapy.
Area of Science:
- Reproductive Medicine
- Gerontology
- Public Health
Background:
- Estrogen replacement therapy (ERT) is a common treatment for postmenopausal symptoms.
- Understanding long-term ERT adherence is crucial for effective patient management and public health strategies.
- Medicaid recipients represent a significant population for whom adherence data is vital.
Purpose of the Study:
- To evaluate the rates and predictors of persistence with estrogen replacement therapy (ERT) in postmenopausal women enrolled in Georgia Medicaid.
- To identify demographic factors influencing long-term adherence to ERT.
Main Methods:
- Retrospective analysis of Georgia Medicaid data from 1992-1994.
- Kaplan-Meier model used to estimate 3-year conditional survival probabilities.
- Identification of 3800 postmenopausal subjects receiving ERT.
Main Results:
- Over 54% of women remained compliant with ERT for 29 months; 17% continued for the full 35 months.
- White women had a 70% probability of 3-year compliance, compared to 60% for black women.
- Monthly discontinuation rates were 1-1.5% after the second month; younger, white women exhibited the highest adherence.
Conclusions:
- Persistence with ERT varies significantly by race and age in this Medicaid population.
- Targeted interventions may be necessary to improve ERT adherence among underrepresented groups.
- Findings highlight the importance of considering patient demographics in long-term hormone therapy management.