Menopause-related workload in general practice 1996-2005: a retrospective study in the UK.
BACKGROUND
Women with menopausal symptoms often consult with a health professional. Recently, hormone replacement therapy (HRT) prescribing has declined but the impact of this change on other aspects of general practice workload is unclear.


OBJECTIVE
To investigate whether the menopause remains a workload issue.


METHODS
A retrospective observational study of UK general practice (General Practice Research Database) using four random samples of 25000 women aged 45-64 years registered with a general practice during 1996, 1999, 2002 and 2005. We calculated the incidence and prevalence of menopause-related consultation; gynaecology referrals; prescriptions for HRT, clonidine and antidepressants during each year; examined patterns over time and investigated whether the types of preparations had changed.


RESULTS
The prevalence and incidence of menopause-related consultation fell-from 18.1% of women aged 45-64 years consulting at least once in 1996 to 10.4% in 2005. Over time, the proportion of women consulting about the menopause who were not prescribed HRT or clonidine increased. The incidence and prevalence of HRT decreased, mainly between 2002 and 2005. The proportion of women prescribed oral HRT fell while the proportion prescribed cream or pessaries/suppositories increased, particularly among women without a hysterectomy. Referrals to gynaecology and the incidence and prevalence of clonidine prescribing increased but remained uncommon. Patterns of antidepressant prescribing did not appear menopause related.


CONCLUSIONS
Although menopause-related workload has decreased over time, in 2005, over 10% of women aged 45-64 years consulted for a menopause-related matter. This suggests that the menopause remains an important part of UK general practice work.
Centre of Academic Primary Care, University of Aberdeen, Foresterhill Health Centre, Westburn Road, Aberdeen AB25 2AY, UK. l.iversen@abdn.ac.uk
Lisa
L
Iversen
Elizabeth K
EK
Delaney
Philip C
PC
Hannaford
Corri
C
Black
D000928:Antidepressive Agents / Q000627:therapeutic use; D003000:Clonidine / Q000627:therapeutic use; D005260:Female; D058006:General Practice / Q000706:statistics & numerical data*; D020249:Hormone Replacement Therapy / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D008593:Menopause; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D015995:Prevalence; D012017:Referral and Consultation / Q000592:standards; D012189:Retrospective Studies; D006113:United Kingdom / Q000453:epidemiology; D016526:Workload / Q000706:statistics & numerical data*
D000928:Antidepressive Agents; D003000:Clonidine