Changes in U.S. prescribing patterns of menopausal hormone therapy, 2001-2003.
OBJECTIVE
In 2002, the combination estrogen-progestin hormone therapy (HT) treatment arm of the Women's Health Initiative was terminated early because cardiovascular and cancer risks were identified, while the estrogen-only therapy (ET) arm of this trial continued. We investigated hormone therapy prescription practice changes between 2001 and 2003 to explore the effects of the clinical trial results.


METHODS
Data were obtained from the National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey for the years 2001 through 2003. These nationally representative surveys sample medical encounters in nonfederally employed physician's offices and outpatient departments of nonfederal short-stay and general hospitals. The proportion and rate of visits with ET and HT prescriptions were calculated. Logistic regression was used to estimate change over time accounting for patient and provider characteristics.


RESULTS
Between 2001 and 2003, the number of visits with menopausal hormone prescriptions fell from 26.5 million to 16.9 million. Almost three-quarters of hormone visits were for ET prescriptions. The decrease in the rate of visits was slightly larger for HT prescription visits (44%) than ET prescription visits (35%). The rate of decline was highest among women 50 years of age and over. After controlling for covariates, there was no significant difference in the decline by hormone type.


CONCLUSIONS
These nationally representative data indicate substantial declines in menopausal hormone prescriptions coinciding with clinical trial results on HT. These declines occurred among all types of therapy and patient characteristics.


METHODS
II-3.
Hing
Esther
E
Division of Health Care Statistics, and Office of Analysis and Epidemiology, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Maryland 20782, USA. EHing@cdc.gov
Brett
Kate M
KM
D000328:Adult; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D004363:Drug Utilization / Q000706:statistics & numerical data / Q000639:trends*; D015914:Estrogen Replacement Therapy / Q000706:statistics & numerical data / Q000639:trends*; D004967:Estrogens / Q000627:therapeutic use; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D016015:Logistic Models; D008593:Menopause; D008875:Middle Aged; D009819:Office Visits / Q000706:statistics & numerical data / Q000639:trends; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data / Q000639:trends*; D011372:Progestins / Q000627:therapeutic use; D014481:United States
D004967:Estrogens; D011372:Progestins