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Effect of bone density evaluation on hormone replacement therapy prescription
S Rozenberg1, M Kroll, J Vandromme
1Interdisciplinary Group on Osteoporosis, Free Universities of Brussels (VUB-ULB), St Peter Hospital, Brussels, Belgium.
Maturitas
|May 1, 1996
Summary
Bone Mineral Density (BMD) results influenced hormone replacement therapy (HRT) prescription in a limited number of postmenopausal women and physicians. While lower BMD showed a trend towards increased HRT prescription, it was not a significant factor for most.
Area of Science:
- Endocrinology and Metabolism
- Women's Health
- Medical Decision Making
Background:
- Postmenopausal hormone replacement therapy (HRT) is a common treatment for various symptoms.
- Bone Mineral Density (BMD) is a key indicator of osteoporosis risk in postmenopausal women.
- The influence of BMD results on HRT prescription decisions requires further investigation.
Purpose of the Study:
- To evaluate the impact of Bone Mineral Density (BMD) test results on the prescription of hormone replacement therapy (HRT).
- To determine if gynaecologists' HRT prescription patterns are influenced by varying BMD levels in simulated postmenopausal cases.
Main Methods:
- 29 postmenopausal women's charts were used to create 4 simulated case groups with differing BMD Z-scores.
- 10 gynaecologists assessed these simulated cases for HRT prescription eligibility, unaware of the BMD manipulation.
- Statistical analyses, including Friedman analysis of variance and Cochran Q test, were employed.
Main Results:
- An overall HRT treatment rate of 74.2% was observed, with higher rates in groups with lower BMD.
- A significant variation in prescription frequency was noted among the 10 gynaecologists (63%-87%).
- BMD results influenced HRT prescription in a statistically significant manner for only one physician.
Conclusions:
- BMD measurement appears to be a determinant factor for HRT prescription in a limited patient and physician subset.
- BMD may aid in decision-making for HRT, particularly for reluctant patients or those with relative contraindications.
- Physician awareness of BMD investigation utility could enhance its role in guiding HRT decisions.