Healthy Skepticism Library item: 7700

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Publication type: Journal Article

Thunell L, Milsom I, Schmidt J, Mattsson LA.
Scientific evidence changes prescribing practice--a comparison of the management of the climacteric and use of hormone replacement therapy among Swedish gynaecologists in 1996 and 2003.
BJOG 2006 Jan; 113:(1):15-20
http://www.blackwell-synergy.com/doi/abs/10.1111/j.1471-0528.2005.00805.x

Abstract:

OBJECTIVES: To study changes in attitudes, knowledge and management strategies concerning hormone replacement therapy (HRT) among gynaecologists in Sweden.

DESIGN: Comparative questionnaire study.

SETTING: National survey.

POPULATION: Practising gynaecologists.

METHODS: In 1996, gynaecologists in Sweden (n= 1323) were invited to return a postal questionnaire concerning their attitudes, knowledge and management strategies concerning HRT. They were also asked about their own use of HRT. In 2003, a similar questionnaire was sent to practising gynaecologists (n= 1320) in Sweden.

MAIN OUTCOME MEASURES: Attitudes to and personal use of HRT.

RESULTS: The response rate was 76% in 2003 when 11% of the gynaecologists thought that all women without contraindications should be offered HRT compared with 44% in 1996 and 89% found it difficult to evaluate pros and cons with HRT in a clinical situation (74% in 1996). More gynaecologists in 2003 believed that HRT increased the risk for breast cancer (95% vs 71%). Twenty-five percent in 2003 stated that risk factors for osteoporosis were absolute indications for HRT (60% in 1996). Current ischaemic heart disease was considered to be an indication for HRT by 7% in 2003 (60% in 1996). In 2003, current use of HRT was reported by 71% of female menopausal gynaecologists (88% in 1996).

CONCLUSIONS: Swedish gynaecologists were more cautious in their management strategies concerning HRT in 2003 compared with 1996, probably influenced by results from the Heart and Estrogen/Progestin Replacement Study (HERS) and Women’s Health Initiative (WHI) studies. Current use of HRT was still high among female gynaecologists, although it had decreased since 1996.

Keywords:
Publication Types: Comparative Study Research Support, Non-U.S. Gov't MeSH Terms: Adult Aged Attitude of Health Personnel* Attitude to Health* Climacteric* Female Gynecology* Hormone Replacement Therapy* Humans Male Middle Aged Physician's Practice Patterns* Sweden