title: Scientific evidence changes prescribing practice--a comparison of the management of the climacteric and use of hormone replacement therapy among Swedish gynaecologists in 1996 and 2003.
abstract: OBJECTIVE
  To study changes in attitudes, knowledge and management strategies concerning hormone replacement therapy (HRT) among gynaecologists in Sweden.
  
  
  METHODS
  Comparative questionnaire study.
  
  
  METHODS
  National survey.
  
  
  METHODS
  Practising gynaecologists.
  
  
  METHODS
  In 1996, gynaecologists in Sweden (n= 1323) were invited to return a postal questionnaire concerning their attitudes, knowledge and management strategies concerning HRT. They were also asked about their own use of HRT. In 2003, a similar questionnaire was sent to practising gynaecologists (n= 1320) in Sweden.
  
  
  METHODS
  Attitudes to and personal use of HRT.
  
  
  RESULTS
  The response rate was 76% in 2003 when 11% of the gynaecologists thought that all women without contraindications should be offered HRT compared with 44% in 1996 and 89% found it difficult to evaluate pros and cons with HRT in a clinical situation (74% in 1996). More gynaecologists in 2003 believed that HRT increased the risk for breast cancer (95% vs 71%). Twenty-five percent in 2003 stated that risk factors for osteoporosis were absolute indications for HRT (60% in 1996). Current ischaemic heart disease was considered to be an indication for HRT by 7% in 2003 (60% in 1996). In 2003, current use of HRT was reported by 71% of female menopausal gynaecologists (88% in 1996).
  
  
  CONCLUSIONS
  Swedish gynaecologists were more cautious in their management strategies concerning HRT in 2003 compared with 1996, probably influenced by results from the Heart and Estrogen/Progestin Replacement Study (HERS) and Women's Health Initiative (WHI) studies. Current use of HRT was still high among female gynaecologists, although it had decreased since 1996.
authors.affiliation: Department of Obstetrics and Gynecology, Sahlgrenska University Hospital/Ostra, Göteborg, Sweden.
authors.forename: Louise
authors.initials: L
authors.lastname: Thunell
authors.forename: Ian
authors.initials: I
authors.lastname: Milsom
authors.forename: Johanna
authors.initials: J
authors.lastname: Schmidt
authors.forename: Lars-Ake
authors.initials: LA
authors.lastname: Mattsson
mesh_terms: D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D002979:Climacteric; D005260:Female; D006176:Gynecology; D020249:Hormone Replacement Therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D013548:Sweden