Utilization pattern of hormone therapy in UK general practice between 1996 and 2015: a descriptive study

Area of Science:

• Reproductive Medicine
• Public Health
• Clinical Pharmacology

Background:

• Concerns regarding increased risks of cardiovascular disease (CVD) and breast cancer associated with hormone therapy (HT) emerged, leading to guideline revisions in 2003/2004.
• These revisions advised individualized HT prescribing, resulting in a significant decrease in HT use between 2002 and 2005.

Purpose of the Study:

• To analyze long-term trends in HT utilization within UK general practice.
• To assess changes in HT prescribing patterns following updated safety guidelines and evidence of associated risks.

Main Methods:

• A descriptive study utilizing the UK Clinical Practice Research Datalink (1996-2015).
• Quantified annual proportions of overall and new HT use in women aged 40-79 years.
• Described HT utilization patterns (drug type, route, dose) in relation to CVD and breast cancer prevalence.

Main Results:

• Overall HT use decreased from 9.4% (2006) to 7.5% (2015), with HT initiation halving by 2005.
• The mean age of HT users increased, while CVD prevalence in users decreased; breast cancer prevalence showed a continuous rise.
• Trends indicated a shift towards estrogen therapy, vaginal HT, and lower doses post-2003, particularly in high-risk subpopulations.

Conclusions:

• HT guideline changes in UK clinical practice have promoted safer HT use.
• These changes appear particularly beneficial for women with pre-existing cardiovascular disease or breast cancer.