title: Postmenopausal hormonal support: discontinuation of raloxifene versus estrogen.
abstract: OBJECTIVE
  To determine possible differences in continuation among women initiating treatment with the selective estrogen receptor modulator raloxifene, versus those initiating treatment with estrogen-containing regimens.
  
  
  METHODS
  A pharmacy prescription database search for refill patterns. The study subjects were members of Kaiser Foundation Health Plan, a large health maintenance organization; 1,394 women age >or=60 years who filled index prescriptions for either raloxifene (n = 331) or systemic estrogens (n = 1,063) between April 1998 and March 1999. The main outcome measure was discontinuation based on prescription refill patterns through December 2000.
  
  
  RESULTS
  At 24 months, the probabilities of discontinuing were 56% for women starting raloxifene compared to 72% for women starting estrogens. The likelihood of discontinuation was significantly less among women starting raloxifene than among those starting estrogen (hazard ratio = 0.75; 95% confidence interval = 0.64-0.88). Adjustments for age and prescriber specialty did not affect the risk.
  
  
  CONCLUSIONS
  We conclude that discontinuation of estrogen by women well beyond the age of menopause is high; more than two-thirds discontinue within 2 years of starting. Women starting therapy with raloxifene are 25% percent less likely to discontinue their medication than those starting estrogen, providing some promise that long-term benefits of raloxifene may be more easily achieved than those of estrogen.
authors.affiliation: Division of Research, Kaiser Permanente Medical Care Program, Oakland, California 94611, USA.
authors.forename: J
authors.initials: J
authors.lastname: Kayser
authors.forename: B
authors.initials: B
authors.lastname: Ettinger
authors.forename: A
authors.initials: A
authors.lastname: Pressman
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015914:Estrogen Replacement Therapy; D005260:Female; D006801:Humans; D017258:Medroxyprogesterone Acetate / Q000627:therapeutic use; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000517:prevention & control*; D010349:Patient Compliance; D016016:Proportional Hazards Models; D020849:Raloxifene Hydrochloride / Q000627:therapeutic use*; D020845:Selective Estrogen Receptor Modulators / Q000627:therapeutic use*
chemical_list: D020845:Selective Estrogen Receptor Modulators; D020849:Raloxifene Hydrochloride; D017258:Medroxyprogesterone Acetate