Hormone therapy use in women veterans accessing veterans health administration care: a national cross-sectional study.
Hormone therapy use in women veterans accessing veterans health administration care: a national cross-sectional study.
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接受退伍军人健康管理护理的女性退伍军人中激素疗法的使用：一项全国横断面研究。
DOI：
10.1007/s11606-014-3073-9
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发表时间：
2015
影响因子：
5.7
通讯作者：
Haskell,SallyG
中科院分区：
文献类型：
--
作者：
Gerber,MeganR;King,MatthewW;Pineles,SuzanneL;Wiltsey-Stirman,Shannon;Bean-Mayberry,Bevanne;Japuntich,SandraJ;Haskell,SallyG
摘要接受 VA（退伍军人管理局）护理的女性退伍军人大多数年龄在 45 至 65 岁之间。了解该群体如何管理更年期对于优化她们的健康非常重要。 目的 全国人口估计显示，45 岁以上女性激素治疗 (HT) 的使用率为 4.7%（2009-2010 年）。我们的研究描述了 VA 女性退伍军人使用 HT 的频率，并检查了心理健康 (MH) 是否可以预测 HT 使用。设计这是对 2009 财年退伍军人事务部国家行政数据的横断面分析。参与者 45 岁以上接受 VA 门诊护理的女退伍军人 (N= 157,195) 被纳入分析中。主要措施以 HT 使用为变量的逻辑回归分析因变量。关键结果 平均年龄为 59.4 岁（SD = 12.2，范围 = 46–110），所有女性中有 16,227 名 (10.3%) 使用 HT。子宫切除术（OR 3.99 [3.53, 4.49]）和骨质疏松症（1.34 [1.27, 1.42]）是 HT 使用的最强医学指标。样本中共有 49,557 名 (31.5%) 女性至少接受过一次 MH 疾病的初步诊断，并且比没有 MH 诊断的女性更有可能使用 HT（未调整 OR 1.56，95% CI [1.50，1.61]）。在控制人口统计和医疗合并症后，患有情绪障碍（抑郁/躁郁症）或焦虑症（创伤后应激障碍（PTSD）、其他焦虑症诊断）的女性退伍军人更有可能使用 HT。 结论 使用 VA 的女性退伍军人中 HT 使用率是普通人群的两倍以上。之前的研究表明，女性退伍军人以相当的比例停止接受 HT，但这些数据表明，退伍军人管理局 HT 使用量的下降并没有跟上平民医疗保健的下降速度。 MH 诊断与 HT 使用的关联表明 MH 在 VA 率中发挥着重要作用。需要进一步研究以了解患者和提供者的影响因素。
ABSTRACTThe majority of women Veterans using VA (Veterans Administration) care fall in the 45–65 year-old age range. Understanding how menopause is managed in this group is of importance to optimizing their health.OBJECTIVENational population estimates showed a prevalence of hormone therapy (HT) use by women over 45 years of 4.7 % (2009–2010). Our study described the frequency of HT use among women Veterans in VA, and examined whether mental health (MH) was predictive of HT use.DESIGNThis was a cross-sectional analysis of national VA administrative data for fiscal year 2009.PARTICIPANTSWomen Veterans over the age of 45 (N= 157,195) accessing VA outpatient care were included in the analysis.MAIN MEASURESLogistic regression analyses using HT use as the dependent variable.KEY RESULTSMean age was 59.4 years (SD =12.2, range =46–110), and 16,227 (10.3 %) of all women used HT. Hysterectomy (OR 3.99 [3.53, 4.49]) and osteoporosis (1.34 [1.27, 1.42]) were the strongest medical indicators of HT use. A total of 49,557 (31.5 %) women in the sample received at least one primary diagnosis of a MH disorder and were more likely to use HT than women with no MH diagnoses (unadjusted OR 1.56, 95 % CI [1.50, 1.61]). Women Veterans with a mood disorder (depression/bipolar) or anxiety disorder [post-traumatic stress disorder (PTSD), other anxiety diagnoses] were more likely to use HT after controlling for demographics and medical comorbidity.CONCLUSIONThe prevalence of HT use among women Veterans using VA is more than twice that of the general population. Prior work suggested that women Veterans were discontinuing HT at comparable rates, but these data demonstrate that decline in VA HT use has not kept pace with that of civilian medical care. The association of MH diagnosis with HT use suggests that MH plays an important role in VA rates. Further study is needed to understand contributing patient and provider factors.