Hormone therapy initiation after the Women's Health Initiative.
OBJECTIVE
To describe hormone therapy (HT) initiation after the 2002 publication of the Women's Health Initiative.


METHODS
Observational cohort (1999-2003) of women ages 40 to 79 years, five health plans, used HT in July 2002 and subsequently discontinued or never used before August 2002.


RESULTS
Of discontinuers, 15.8% (3,203 of 20,205) reinitiated HT. Reinitiation was higher among estrogen users (23.8%) versus estrogen with progestin users (11.3%), and lower among those with diabetes (relative risk [RR]=0.68, 95% CI: 0.61-0.76), cardiovascular disease (RR=0.87, 95% CI: 0.83-0.92), and hyperlipidemia (RR=0.83, 95% CI: 0.79-0.88). Only 2.3% (2,072 of 90,261) of never users initiated (August 2002 to December 2003). First-time initiation was associated with cardiovascular disease (RR=1.17, 95% CI: 1.10-1.25) and hyperlipidemia (RR=1.24, 95% CI: 1.17-1.33) and was less common among those with diabetes (RR=0.70, 95% CI: 0.63-0.79).


CONCLUSIONS
After the Women's Health Initiative, a minority of women reinitiated or became first-time initiators of HT. Women with cardiovascular disease, diabetes, and hyperlipidemia were less likely to reinitiate; women with cardiovascular disease and hyperlipidemia were more likely to be first-time initiators.
Newton
Katherine M
KM
Group Health Center for Health Studies, Seattle, WA 98101, USA. newton.k@ghc.org
Buist
Diana S M
DS
Yu
Onchee
O
Hartsfield
Cynthia L
CL
Andrade
Susan E
SE
Wei
Feifei
F
Connelly
Maureen T
MT
Chan
K Arnold
KA
D000328:Adult; D000368:Aged; D015331:Cohort Studies; D004333:Drug Administration Routes; D004334:Drug Administration Schedule; D015914:Estrogen Replacement Therapy / Q000639:trends*; D004967:Estrogens / Q000008:administration & dosage*; D005260:Female; D006279:Health Maintenance Organizations; D006801:Humans; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D011372:Progestins / Q000008:administration & dosage*; D016387:Women's Health
D004967:Estrogens; D011372:Progestins