Provider attributes associated with hormone therapy prescribing frequency.
OBJECTIVE
The aim of this study was to identify provider characteristics associated with hormone therapy prescribing.


METHODS
The study design is cross-sectional. In December 2005, we mailed surveys to providers practicing in two integrated healthcare delivery systems located in the northwestern and northeastern United States; 379 responded (74%) and 249 (49% of total) granted access to their automated data. Data included provider demographics, practice characteristics, and perceptions about hormone therapy. Provider-specific annual hormone therapy prescribing frequency was calculated as days supply of hormone therapy filled divided by the number of visits (among women aged 45-80 y). Factors associated with higher rates of hormone therapy prescribing were identified using bivariate and multivariate analyses.


RESULTS
We report results separately for primary care providers (internists and family practitioners) and obstetrician/gynecologists because significant correlates differed in these two groups. For both primary care providers and obstetrician/gynecologists, in multivariate analyses, hormone therapy prescribing varied by site (P < or = 0.002) and years at the healthcare organization (P < or = 0.01). For primary care providers only, higher hormone therapy prescribing was associated with reported expert knowledge of the hormone therapy trials (P < or = 0.001). For obstetrician/gynecologists, higher hormone therapy prescription was related to feeling well prepared to counsel women on hormone therapy (P < or = 0.007), believing that the risks of estrogen with progestogen had been exaggerated (P = 0.04), and seeing younger aged patients (P = 0.03).


CONCLUSIONS
After the release of the Women's Health Initiative findings and practicing under similar clinical guidelines, hormone therapy prescribing is associated with providers' confidence, practice location, and time with a healthcare organization.
Spangler
Leslie
L
Group Health Center for Health Studies, University of Washington Seattle, WA 98101, USA. spangler.l@ghc.org
Reed
Susan D
SD
Nekhyludov
Larissa
L
Grothaus
Louis C
LC
LaCroix
Andrea Z
AZ
Newton
Katherine M
KM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D011307:Drug Prescriptions; D015914:Estrogen Replacement Therapy / Q000706:statistics & numerical data*; D005194:Family Practice; D005260:Female; D006176:Gynecology; D006282:Health Personnel; D006801:Humans; D007388:Internal Medicine; D008297:Male; D008593:Menopause; D008875:Middle Aged; D009774:Obstetrics; D010818:Practice Patterns, Physicians'; D012307:Risk Factors