After the Women's Health Initiative: decision making and trust of women taking hormone therapy.
OBJECTIVE
To describe decision making and trust of women who were on hormone therapy (estrogen and progestin or estrogen alone) when the Women's Health Initiative findings were initially released July 9, 2002.


METHODS
Telephone surveys of 204 patients randomly selected from a large academic primary care practice (66% response rate) were conducted from July to September 2003. Women age 50 years and older who were taking hormone therapy on July 9, 2002, were included. The survey assessed: prevalence of discontinuing hormone therapy; knowledge of and reactions to the Women's Health Initiative; trust in medical recommendations; and future prevention behavior.


RESULTS
Of 204 women, their mean age was 61 years, 70% were white, 56% were college educated, and 54% were taking both estrogen and progestin. Most (94%) had heard of the Women's Health Initiative and the majority (70%) stopped hormone therapy. Being nonwhite (adjusted RR 1.37, 95% CI [1.16-1.48]) and having taken estrogen and progestin (1.37, [1.18-1.49]) were significantly associated with stopping hormone therapy. Among women who had heard of the Women's Health Initiative (n = 191), 26% reported losing trust in medical recommendations generally and 34% were less willing than before the Women's Health Initiative to take new drugs to prevent heart disease. Nonwhites were less willing than whites to take new drugs for heart disease prevention (aRR 1.58 [1.02-2.18]).


CONCLUSIONS
Most women discontinued hormone therapy after the Women's Health Initiative results were published. Given their experience with hormone therapy, some women, particularly nonwhites, are now less trusting of medical recommendations and less likely to take drugs for cardiovascular disease prevention.
Schonberg
Mara A
MA
Division of General Medicine and Primary Care, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA. mschonbe@bidmc.harvard.edu
Davis
Roger B
RB
Wee
Christina C
CC
D000046:Academic Medical Centers; D000368:Aged; D003657:Decision Making; D015914:Estrogen Replacement Therapy / Q000009:adverse effects / Q000706:statistics & numerical data*; D005194:Family Practice; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008875:Middle Aged; D010353:Patient Education as Topic; D015995:Prevalence; D011320:Primary Health Care; D016032:Randomized Controlled Trials as Topic; D011795:Surveys and Questionnaires; D035502:Trust; D014481:United States; D016387:Women's Health / Q000208:ethnology