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Healthy Skepticism Library item: 7717

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

 

Publication type: Journal Article

Kang BM, Kim MR, Park HM, Yoon BK, Lee BS, Chung HW, Cho SH, Choi H, Kim JG.
Attitudes of Korean clinicians to postmenopausal hormone therapy after the Women's Health Initiative study.
Menopause 2006 Jan-Feb; 13:(1):125-9
http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?doi=10.1097/01.gme.0000191211.51232.9d


Abstract:

OBJECTIVE: To assess the attitudes of Korean physicians toward hormone therapy (HT) after publication of the Women’s Health Initiative (WHI) study.

DESIGN: Self-administered questionnaires, consisting of 22 items, were sent by mail to the members of the Korean Society of Menopause.

RESULTS: More than 95% of Korean physicians were aware of the WHI study. The HT prescription rate decreased by 16% after publication of the WHI report; approximately half of the physicians who continued prescribing HT changed their prescriptions. The largest decreases occurred in regimens using conjugated equine estrogens and medroxyprogesterone acetate, for which prescriptions of sequential and continuous-combined regimens decreased by 20.7% and 22.7%, respectively. In contrast, the prescription rate for tibolone increased by 3.6%. Approximately 30% of physicians changed from standard to low doses, and 67.8% shortened the duration of HT. After publication of the WHI report, the main reasons for not prescribing or discontinuing HT were patient refusal and increased risk of cardiovascular disease, rather than breast cancer risk. After publication of the WHI report, the number of physicians who prescribed alternative or complementary medicines increased, the rate of HT prescription for the prevention of osteoporosis decreased, and the number of postmenopausal outpatients decreased.

CONCLUSIONS: Despite the results of the WHI report, most Korean physicians who participated in this study continued prescribing HT; however, approximately half of those who continued prescribing HT changed their prescriptions. The greatest change occurred in regimens using conjugated equine estrogens and medroxyprogesterone acetate.

Keywords:
Publication Types: Research Support, Non-U.S. Gov't MeSH Terms: Adult Attitude of Health Personnel* Estrogen Replacement Therapy*/methods Estrogen Replacement Therapy*/trends Estrogens, Conjugated (USP)/administration & dosage Female Humans Korea Male Medroxyprogesterone 17-Acetate/administration & dosage Middle Aged Norpregnenes/administration & dosage Osteoporosis, Postmenopausal/prevention & control Physician's Practice Patterns/trends* Postmenopause* Prescriptions, Drug/statistics & numerical data Questionnaires Randomized Controlled Trials* Women's Health* Substances: Estrogens, Conjugated (USP) Norpregnenes tibolone Medroxyprogesterone 17-Acetate

 

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Far too large a section of the treatment of disease is to-day controlled by the big manufacturing pharmacists, who have enslaved us in a plausible pseudo-science...
The blind faith which some men have in medicines illustrates too often the greatest of all human capacities - the capacity for self deception...
Some one will say, Is this all your science has to tell us? Is this the outcome of decades of good clinical work, of patient study of the disease, of anxious trial in such good faith of so many drugs? Give us back the childlike trust of the fathers in antimony and in the lancet rather than this cold nihilism. Not at all! Let us accept the truth, however unpleasant it may be, and with the death rate staring us in the face, let us not be deceived with vain fancies...
we need a stern, iconoclastic spirit which leads, not to nihilism, but to an active skepticism - not the passive skepticism, born of despair, but the active skepticism born of a knowledge that recognizes its limitations and knows full well that only in this attitude of mind can true progress be made.
- William Osler 1909