The impact of the Women's Health Initiative on discontinuation of postmenopausal hormone therapy: the Minnesota Heart Survey (2000-2002).
BACKGROUND
The Women's Health Initiative (WHI) Data Safety and Monitoring Board terminated the trial arm of the estrogen plus progestin combined hormone therapy early after observing an excess of harm relative to benefit of this therapy.


METHODS
To learn how postmenopausal hormone therapy (PMT) use in a community setting was affected by the WHI results, we resurveyed current users of PMT in August 2002 to January 2003 after publication of the WHI findings from our Minnesota Heart Survey (MHS) cohort (2000-2002), a cross-sectional epidemiological survey in the Minneapolis-St. Paul, Minnesota, area. We evaluated women's interpretation of the WHI results, reports of their physicians' recommendations, and the impact of these on PMT use in this group.


RESULTS
We obtained an excellent response rate (97.9%, 185 of 189). Almost a third of women with an intact uterus but few women with a hysterectomy discontinued their PMT regimen within the first 6 months after the WHI research results were released. The majority of women in our study consulted their physician about whether to discontinue PMT. Women in the intact uterus group who started their PMT regimen for menopausal symptoms were less likely to discontinue PMT. Of women who continued their PMT regimen, the majority cited relief of menopausal symptoms or physician recommendation for continuation of PMT or both. Almost a third of the women interviewed reported being confused, worried, or nervous about the media reports of the WHI results.


CONCLUSIONS
These results suggest effective dissemination of WHI information by the media and physicians and significant changes in patterns of PMT use in the community.
Barber
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Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis, Minnesota 55454, USA. barber@epi.umn.edu
Margolis
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Luepker
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Arnett
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DK
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D001943:Breast Neoplasms / Q000139:chemically induced; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D015914:Estrogen Replacement Therapy / Q000009:adverse effects / Q000523:psychology / Q000706:statistics & numerical data*; D005260:Female; D006266:Health Education / Q000592:standards; D006331:Heart Diseases / Q000139:chemically induced; D006801:Humans; D008875:Middle Aged; D008910:Minnesota / Q000453:epidemiology; D017698:Postmenopause / Q000187:drug effects* / Q000523:psychology; D011788:Quality of Life; D018570:Risk Assessment; D012307:Risk Factors; D020521:Stroke / Q000139:chemically induced; D011795:Surveys and Questionnaires; D013997:Time Factors; D016387:Women's Health