Hormone therapy use and prescription durations of menopausal women in Taiwan: a 5 years' National Cohort study.
OBJECTIVE
To describe the prevalence and associated factors of hormone replacement therapy (HRT)-related utilization in a national representative fixed cohort in Taiwan.


METHODS
The study population are women aged 40 years and over in Taiwan. Our data, provided by National Health Research Institutes, are the sampled registry information of 37,315 beneficiaries of National Health Insurance from 2000 to 2004. The dependent variables were HRT-related utilizations, including physician contact, HRT utilization rate/duration/patterns (new, prevalent and discontinue users). The independent variables were age, time, prior co-morbidities and prior utilization pattern. We used generalized estimating equation (GEE) model for repeated measurement analysis.


RESULTS
The outpatient contact rates for menopause syndrome were low, though the HRT prescription rate among those who have contact were high. GEE shows that age, time, prior co-morbidities/HRT utilization patterns were significantly associated with all types of HRT-related utilizations, which all declined significantly following the publications of Women's Health Initiative (WHI) in 2002. The magnitudes of reduction, though similar in 2003-2004, were greater for physician contact and HRT durations than that of HRT prescription rate for those have contacts in 2002. Besides, the percentages of new (discontinue) users have already declined (increased) since 2001 although it had not declined until 2003 for the continued users.


CONCLUSIONS
WHI publications have great impact on HRT-related utilizations. However, the response of the women was quicker and much drastic than that of the physicians in 2002. Besides, the efforts of the various women's associations before WHI might have some contribution to the declined (increased) of new (discontinued) users.
Kuo
De-Jhen
DJ
Department of Health Administration, Tzu Chi College of Technology, Hualien, Taiwan; Institute of Health and Welfare Policy and Research Center of Health and Welfare Policy, College of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC.
Lee
Yue-Chune
YC
Huang
Weng-Foung
WF
D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003953:Diagnosis-Related Groups; D017723:Drug Utilization Review; D015914:Estrogen Replacement Therapy / Q000706:statistics & numerical data*; D005260:Female; D019584:Hot Flashes / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D008593:Menopause / Q000187:drug effects; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012042:Registries; D013624:Taiwan