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Hormone therapy prescribing patterns in the United States
Diana S M Buist1, Katherine M Newton, Diana L Miglioretti
1Center for Health Studies, Group Health Cooperative, Seattle, Washington 98101, USA. buist.d@ghc.org
Obstetrics and Gynecology
|November 2, 2004
Summary
The Women's Health Initiative trial results led to immediate increases in hormone therapy (HT) discontinuation and significant declines in both HT and estrogen therapy (ET) initiation among US women.
Area of Science:
- Reproductive Medicine
- Pharmacology
- Public Health
Background:
- Hormone therapy (HT), including estrogen plus progestin (HT) and estrogen alone (ET), was widely prescribed for menopausal symptoms.
- The Women's Health Initiative (WHI) trial provided critical safety data on HT use.
Purpose of the Study:
- To analyze changes in prescribing patterns for HT and ET in the US.
- To assess the impact of the WHI trial results on HT and ET initiation and discontinuation rates.
Main Methods:
- An observational cohort study of 169,586 women aged 40-80 years was conducted.
- Automated pharmacy data from 5 US health maintenance organizations were used to track HT and ET dispensing from September 1999 to December 2002.
Main Results:
- HT prevalence decreased by 46% (14.6% to 7.9%) and ET use by 28% (12.6% to 9.1%) post-WHI results.
- HT discontinuation surged from 2.5% to 13.8%, while initiation rates for both HT and ET dropped significantly.
Conclusions:
- The WHI trial results rapidly influenced HT and ET prescribing, causing immediate increases in discontinuation and decreases in initiation.
- Further research is needed to understand reasons for continued HT use and develop strategies to address them.