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Significant fall in hormone replacement therapy prescription in general practice
Alm Lagro-Janssen1, M W A Knufing, L Schreurs
1Department of Primary Care and Community Care, Radboud University Nijmegen Medical Centre, 6500 HB Nijmegen, The Netherlands. a.lagro-janssen@elg.umcn.nl
Family Practice
|April 22, 2010
Summary
General practitioners rapidly reduced hormone replacement therapy (HRT) prescriptions following major study publications. HRT decisions were not linked to women's emotional or psychiatric health issues.
Area of Science:
- General Practice
- Women's Health
- Pharmacovigilance
Background:
- Hormone replacement therapy (HRT) was widely used but associated with significant health risks.
- Major studies like the Women's Health Initiative (WHI) and Million Women Study (2002-2003) raised safety concerns regarding HRT.
- Past HRT use affected one in five women, necessitating a re-evaluation of its prescription patterns.
Purpose of the Study:
- To evaluate HRT prescription trends in general practice for menopausal symptoms.
- To assess changes in HRT prescribing before and after key 2002-2003 study publications.
- To correlate HRT use with patient co-morbidity, co-medication, and consultation frequency.
Main Methods:
- Utilized data from a Dutch Continuous Morbidity Registration system (1999-2007).
- Compared women with new menopausal symptoms who received HRT versus those who did not.
- Matched control groups for age, socio-economic status, and general practice to ensure comparability.
Main Results:
- HRT prescriptions dropped significantly post-2002, from 37% to 14% (2003) and 4% (2004).
- Women consulting for menopausal symptoms, with or without HRT, had more nervous complaints and higher GP visit frequency.
- Prescribing HRT was not associated with specific emotional or psychiatric conditions in menopausal women.
Conclusions:
- General practitioners swiftly adopted new guidelines on HRT prescription.
- The study highlights rapid clinical practice changes in response to evidence-based medicine.
- HRT prescription decisions were independent of menopausal women's psychological health profiles.
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