OBJECTIVES: The purpose of this study was to compare hormone replacement therapy (HRT) prescribing frequency to provider characteristics, attitudes and beliefs about menopause and HRT. METHODS: There was a mailed survey of providers at a large staff-model HMO in Washington state. Participants included 250 family practice physicians, 22 gynecologists, and 13 women's health care specialists and nurse midwives (83% response rate). The primary outcome, "HRT prescribing frequency" (derived from automated pharmacy and visit data) was defined as: the total number of estrogen prescriptions written by the provider and filled by women aged 50-80 years during the 12 months prior to the survey, divided by the number of visits made to the provider by women aged 50-80 years during that same 12-month period. Covariates included provider characteristics and beliefs about menopause and HRT. Logistic regression was used to distinguish providers in the upper 40% versus the lower 60% of HRT prescribing frequency. RESULTS: Controlling for age and practice type, HRT prescribing frequency was lower among men than women providers (odds ratio [OR] 0.38, 95% confidence interval [CI] 0.21-0.65), higher among providers who agreed (vs. disagreed or neutral) that a convincing scientific case has been made that HRT prevents heart disease (OR 2.66, 95% CI 1.53-4.61), and higher among those in the upper tertile vs. lower tertiles of an HRT encouragement scale (OR 2.50, 95% CI 1.29-4.85). CONCLUSIONS: Female providers and providers with positive attitudes toward HRT are the most likely to prescribe it.
OBJECTIVES: The purpose of this study was to compare hormone replacement therapy (HRT) prescribing frequency to provider characteristics, attitudes and beliefs about menopause and HRT. METHODS: There was a mailed survey of providers at a large staff-model HMO in Washington state. Participants included 250 family practice physicians, 22 gynecologists, and 13 women's health care specialists and nurse midwives (83% response rate). The primary outcome, "HRT prescribing frequency" (derived from automated pharmacy and visit data) was defined as: the total number of estrogen prescriptions written by the provider and filled by women aged 50-80 years during the 12 months prior to the survey, divided by the number of visits made to the provider by women aged 50-80 years during that same 12-month period. Covariates included provider characteristics and beliefs about menopause and HRT. Logistic regression was used to distinguish providers in the upper 40% versus the lower 60% of HRT prescribing frequency. RESULTS: Controlling for age and practice type, HRT prescribing frequency was lower among men than women providers (odds ratio [OR] 0.38, 95% confidence interval [CI] 0.21-0.65), higher among providers who agreed (vs. disagreed or neutral) that a convincing scientific case has been made that HRT prevents heart disease (OR 2.66, 95% CI 1.53-4.61), and higher among those in the upper tertile vs. lower tertiles of an HRT encouragement scale (OR 2.50, 95% CI 1.29-4.85). CONCLUSIONS: Female providers and providers with positive attitudes toward HRT are the most likely to prescribe it.
Authors: Susan L Lakey; Susan D Reed; Andrea Z LaCroix; Lou Grothaus; Katherine M Newton Journal: J Womens Health (Larchmt) Date: 2010-11-09 Impact factor: 2.681
Authors: Katherine M Newton; Susan D Reed; Louis C Grothaus; Andrea Z La Croix; Larissa Nekhlyudov; Kelly Ehrlich; Evette J Ludman Journal: Menopause Date: 2010-07 Impact factor: 2.953
Authors: Leslie Spangler; Susan D Reed; Larissa Nekhyludov; Louis C Grothaus; Andrea Z LaCroix; Katherine M Newton Journal: Menopause Date: 2009 Jul-Aug Impact factor: 2.953
Authors: Terry M Bush; Amy E Bonomi; Larissa Nekhlyudov; Evette J Ludman; Susan D Reed; Maureen T Connelly; Lou C Grothaus; Andrea Z LaCroix; Katherine M Newton Journal: J Gen Intern Med Date: 2007-07-18 Impact factor: 5.128