英国初级保健中激素替代疗法处方的不平等:基于人口的队列研究
Jennifer A Hirst1, Wema Meranda Mtika1, Carol Coupland2,3
1Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
BMJ medicine
|October 2, 2025
概括
英格兰的激素替代疗法 (HRT) 处方显示出差异. 白人妇女和富裕地区的妇女比非白人妇女和贫困地区的妇女更频繁地接受HRT,这表明潜在的不平等.
科学领域:
- 生殖健康 生殖健康
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
背景情况:
- 激素替代疗法 (HRT) 是对更年期症状的常见治疗方法.
- 了解HRT的处方模式对于确保公平获得护理至关重要.
- 国家卫生和护理卓越研究所 (NICE) 在2015年的指导旨在在英国标准化更年期护理.
研究的目的:
- 量化英格兰40-60岁女性的HRT按类型和持续时间的处方.
- 确定与接受HRT处方相关的社会人口统计因素.
- 检查NICE指南实施前后的HRT处方趋势.
主要方法:
- 基于人口的队列研究,使用QResearch数据库和电子健康记录.
- 在10年期间 (2013-2023) 对40至60岁的1,978,348名妇女的处方信息分析.
- 研究了HRT采用与种族,贫困和地理区域之间的关联.
主要成果:
- 19.2%的女性接受了两个或更多的HRT处方,HRT组合是最常见的.
- 白人女性 (22.6%) 比其他族群更有可能接受HRT (例如,加勒比8.9%,非洲黑人3.9%).
- 随着社会贫困的增加,HRT处方率下降,伦敦的处方率比其他地区低.
结论:
- 在英国,基于种族,社会经济地位和地理位置,HRT处方存在显著差异.
- 白人女性和富裕地区的女性的HRT处方率更高.
- 调查结果表明,在HRT接入方面存在潜在的不平等现象,需要进一步调查.
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