在患有更年期性尿生殖系统综合征的医疗保险受益者中使用阴道雌激素
Kelsey Gallo1, Chiyuan Amy Zhang2, Claire Burton3
1Endeavor Health, Glenview, Illinois.
JAMA network open
|December 16, 2025
概括
只有9.0%患有更年期生殖尿综合征 (GSM) 的女性接受了阴道雌激素 (VE) 处方. 更年轻,更健康的女性和那些有多种GSM症状的女性更有可能填补处方,突出了护理的差距.
科学领域:
- 妇女健康 妇女健康
- 妇科 妇科医生 妇科
- 药理学 药理学是指药理学的学科.
背景情况:
- 低剂量阴道雌激素 (VE) 是一种安全有效的治疗更年期性尿性综合征 (GSM) 的方法.
- 在现实世界的临床实践中,对GSM的VE的处方频率在很大程度上是未知的.
研究的目的:
- 评估在被诊断为GSM的妇女中使用 VE 处方的情况.
- 为了确定与VE处方主张相关的特定患者特征和临床表型.
主要方法:
- 基于人口的回顾性队列研究,使用医疗保险数据 (2006-2018).
- 包括66岁以上的女性GSM诊断,但不包括最近患有乳腺/子宫内膜癌的女性.
- 使用后勤回归分析了处方要求和患者因素.
主要成果:
- 在1,838,732名患有GSM的女性中,只有9.0%填写了VE处方.
- 年龄较大的女性和具有较高并发症分数的女性接受VE的可能性较低.
- 患有 vulvovaginal 症状或 GSM 多发症的女性更有可能接受 VE,而患有复发性尿路感染的女性的可能性较小.
结论:
- 很大一部分患有GSM的女性没有获得VE处方,这表明治疗中的潜在差距.
- 患者的年龄,整体健康状况和特定的症状集群影响VE处方模式.
- 需要加强教育和改进诊断编码,以优化GSM管理和研究.
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