Physician policies on the use of preventive hormone therapy.
BACKGROUND
Current guidelines recommend that most postmenopausal women be offered preventive hormone therapy (PHT), but there have been no surveys of U.S. physicians' policies since these guidelines appeared. We sought to measure physicians' policies and attitudes about PHT and compare them with the American College of Physicians' guideline on the use of PHT.


METHODS
We used a stratified, randomized survey of gynecologists, family physicians, and general internists in Washington, Alaska, Montana, and Idaho.


RESULTS
Nearly all respondents reported strong belief in the benefits of PHT and felt that the vast majority of their patients should be offered PHT. Where they differed, gynecologists believed even more strongly in its benefits than other respondents. Physicians estimated that 3% of their patients with a uterus were on regimens without any progestin and 23% were on regimens including time without any hormones. Gynecologists ranked mammography first and PHT use second on a list of eight preventive services, while the other respondents ranked smoking cessation first and PHT fourth (P < .0001 for differences).


CONCLUSIONS
Among surveyed physicians, there was near unanimous adoption of policies favoring the recommendation of PHT. Gynecologists believed in it even more strongly than family physicians and general internists and ranked it as more important than counseling about smoking cessation.
Saver
B G
BG
Department of Family Medicine, School of Medicine, University of Washington, Seattle 98195-4795, USA. saver@u.washington.edu
Taylor
T R
TR
Woods
N F
NF
Stevens
N G
NG
D000328:Adult; D000413:Alaska; D001291:Attitude of Health Personnel; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D015914:Estrogen Replacement Therapy / Q000523:psychology / Q000706:statistics & numerical data; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D019538:Health Care Surveys; D006801:Humans; D016014:Linear Models; D008297:Male; D008593:Menopause / Q000523:psychology; D008875:Middle Aged; D015205:Northwestern United States; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D010353:Patient Education as Topic / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*