title: What factors account for hormone replacement therapy prescribing frequency?
abstract: OBJECTIVE
  The purpose of this study was to compare hormone replacement therapy (HRT) prescribing frequency to provider characteristics, attitudes and beliefs about menopause and HRT.
  
  
  METHODS
  There was a mailed survey of providers at a large staff-model HMO in Washington state. Participants included 250 family practice physicians, 22 gynecologists, and 13 women's health care specialists and nurse midwives (83% response rate). The primary outcome, "HRT prescribing frequency" (derived from automated pharmacy and visit data) was defined as: the total number of estrogen prescriptions written by the provider and filled by women aged 50-80 years during the 12 months prior to the survey, divided by the number of visits made to the provider by women aged 50-80 years during that same 12-month period. Covariates included provider characteristics and beliefs about menopause and HRT. Logistic regression was used to distinguish providers in the upper 40% versus the lower 60% of HRT prescribing frequency.
  
  
  RESULTS
  Controlling for age and practice type, HRT prescribing frequency was lower among men than women providers (odds ratio [OR] 0.38, 95% confidence interval [CI] 0.21-0.65), higher among providers who agreed (vs. disagreed or neutral) that a convincing scientific case has been made that HRT prevents heart disease (OR 2.66, 95% CI 1.53-4.61), and higher among those in the upper tertile vs. lower tertiles of an HRT encouragement scale (OR 2.50, 95% CI 1.29-4.85).
  
  
  CONCLUSIONS
  Female providers and providers with positive attitudes toward HRT are the most likely to prescribe it.
authors.affiliation: Center for Health Studies, Group Health Cooperative, 1730 Minor Ave. Suite 1600, Seattle, WA 98101, USA. newton.k@ghc.org
authors.forename: K M
authors.initials: KM
authors.lastname: Newton
authors.forename: A Z
authors.initials: AZ
authors.lastname: LaCroix
authors.forename: D S
authors.initials: DS
authors.lastname: Buist
authors.forename: L A
authors.initials: LA
authors.lastname: Anderson
authors.forename: K
authors.initials: K
authors.lastname: Delaney
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D005260:Female; D006279:Health Maintenance Organizations; D020249:Hormone Replacement Therapy / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008593:Menopause; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D014861:Washington