What factors account for hormone replacement therapy prescribing frequency?
What factors account for hormone replacement therapy prescribing frequency?
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DOI：
10.1016/s0378-5122(01)00185-2
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发表时间：
2001-07-25
期刊：
影响因子：
4.9
通讯作者：
Delaney, K
中科院分区：
文献类型：
--
作者：
Newton, KM;LaCroix, AZ;Delaney, K
目的：本研究的目的是比较激素替代疗法(HRT)的处方频率与提供者对更年期和HRT的特征、态度和信念。方法：对华盛顿州一家大型员工模式HMO的提供者进行邮寄调查。参与者包括250名家庭执业医生、22名妇科医生和13名妇女保健专家和护士助产士(响应率为83%)。主要结果，‘HRT处方频率’(来自自动药房和就诊数据)被定义为：在调查前12个月期间，由提供者开具的、由50-80岁的女性填写的雌激素处方总数除以在同一12个月期间50-80岁的女性到提供者那里就诊的次数。协变量包括提供者的特征和对更年期和激素替代疗法的信念。Logistic回归用于区分HRT处方频率高40%和低60%的提供者。结果：控制年龄和实践类型，男性HRT处方频率低于女性(优势比[OR]0.38，95%可信区间[CI]0.21-0.65)，在同意HRT预防心脏病的令人信服的科学证据的提供者(OR 2.66，95%CI 1.53-4.61)中高于女性(OR 2.50，95%CI 1.29-4.85)，在HRT鼓励量表的上三分位数与下三分位数中更高(OR 2.50，95%CI 1.29-4.85)。结论：女性提供者和对HRT持积极态度的提供者最有可能开出处方。(C)2001爱思唯尔爱尔兰科学有限公司。保留所有权利。
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% Cl 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. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.