Sirpa-Liisa Hovi1, Tiina Karttunen, Helle Karro, Elina Hemminki. 1. National Research and Development Centre for Welfare and Health (STAKES), Health and Social Services, PO Box 220, FIN-00531 Helsinki, Finland. sirpa.hovi@stakes.fi
Abstract
OBJECTIVE: To compare Estonian and Finnish gynaecologists' and general practitioners' (GP) opinions on and prescribing practices in hormone treatment (HT) during and after menopause. METHODS: Data was collected using similar postal questionnaires. In 2000 in Estonia, a random sample included 212 gynaecologists and 288 GPs (68% responded); and in 1989 in Finland, 100 male and 100 female gynaecologists, 100 general practitioner specialists and 100 non-specialists (73% responded). Gynaecologists and GPs were compared to each other within the countries, and the two countries were compared within the specialities. RESULTS: Gynaecologists' opinions of benefits were positive and similar in Estonia and Finland, and more positive than those of GPs. Gynaecologists and GPs in both countries had similar opinions about harms. Gynaecologists were in favour of longer HT than GPs, and longer treatment was recommended in Finland than in Estonia. In both countries a large proportion of physicians (48% of gynaecologists in Estonia and 65% in Finland) stated that they would routinely prescribe HT to all women at menopause without contraindication, regardless of symptoms, and some (31% of gynaecologists in Estonia and 19% in Finland) favoured routine prescribing to all postmenopausal women. CONCLUSIONS: Estonian physicians' positive attitudes suggest increased use of HT. Comparisons of the two countries and specialities suggest that physicians' positive opinions may long predate increased use.
OBJECTIVE: To compare Estonian and Finnish gynaecologists' and general practitioners' (GP) opinions on and prescribing practices in hormone treatment (HT) during and after menopause. METHODS: Data was collected using similar postal questionnaires. In 2000 in Estonia, a random sample included 212 gynaecologists and 288 GPs (68% responded); and in 1989 in Finland, 100 male and 100 female gynaecologists, 100 general practitioner specialists and 100 non-specialists (73% responded). Gynaecologists and GPs were compared to each other within the countries, and the two countries were compared within the specialities. RESULTS: Gynaecologists' opinions of benefits were positive and similar in Estonia and Finland, and more positive than those of GPs. Gynaecologists and GPs in both countries had similar opinions about harms. Gynaecologists were in favour of longer HT than GPs, and longer treatment was recommended in Finland than in Estonia. In both countries a large proportion of physicians (48% of gynaecologists in Estonia and 65% in Finland) stated that they would routinely prescribe HT to all women at menopause without contraindication, regardless of symptoms, and some (31% of gynaecologists in Estonia and 19% in Finland) favoured routine prescribing to all postmenopausal women. CONCLUSIONS: Estonian physicians' positive attitudes suggest increased use of HT. Comparisons of the two countries and specialities suggest that physicians' positive opinions may long predate increased use.