title: Older women and hormone replacement therapy: factors influencing late life initiation.
abstract: OBJECTIVE
  To describe factors associated with initiation of hormone replacement therapy (HRT) by older women.
  
  
  METHODS
  A cross-sectional study of 671 randomly selected women aged 65 to 80 who participated in a larger telephone survey on preventive health behaviors.
  
  
  METHODS
  A large health maintenance organization (HMO) in Seattle, Washington.
  
  
  METHODS
  Of the 521 women who responded (78%), 51 had begun taking HRT at age 60 or older and were identified as initiators. Women who had never used HRT or past users who had begun HRT before age 60 were classified as noninitiators (n = 362). Current users who started HRT before age 60 (n = 108) were excluded.
  
  
  METHODS
  Sources included the telephone survey, automated HMO pharmacy data, and HMO utilization and provider databases.
  
  
  RESULTS
  Initiators were similar to noninitiators with respect to age, marital status, education, and health status. Initiators were more likely to have had a hysterectomy at age 60 or later than noninitiators. Sixty-two percent of the non-initiators said they had received no information about the benefits of HRT from their providers compared with 18% of initiators. HRT initiation was associated with belief in prevention benefits of HRT for fractures and cardiovascular disease and with reported encouragement from the physician to use HRT.
  
  
  CONCLUSIONS
  Other than hysterectomy status, there were few sociodemographic or health characteristics that markedly distinguished older initiators from noninitiators. Our findings show the importance of physician counseling in an older woman's decision to initiate HRT.
authors.affiliation: Epidemiology, Demography, and Biometry Program, National Institute on Aging, Bethesda, MD 20892, USA.
authors.forename: S G
authors.initials: SG
authors.lastname: Leveille
authors.forename: A Z
authors.initials: AZ
authors.lastname: LaCroix
authors.forename: K M
authors.initials: KM
authors.lastname: Newton
authors.forename: N L
authors.initials: NL
authors.lastname: Keenan
mesh_terms: D000367:Age Factors; D000368:Aged; D001294:Attitude to Health; D003430:Cross-Sectional Studies; D015914:Estrogen Replacement Therapy / Q000523:psychology* / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D011795:Surveys and Questionnaires