HRT Decision Making in the Post-WHI Era

后 WHI 时代的 HRT 决策

• 批准号: 7066512
• 负责人: Katherine M. Newton
• 金额: $ 48.54万
• 依托单位: KAISER FOUNDATION HEALTH PLAN OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-06-01 至 2008-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7066512
• 关键词: aging; attitude; behavioral /social science research tag; belief; clinical research; decision making; epidemiology; female; female reproductive system; gynecology; hormone therapy; human middle age (35-64); human old age (65+); human subject; human therapy evaluation; interview; longitudinal human study; primary care physician; women' s health

DESCRIPTION (provided by applicant): The Women's Health Initiative has changed our understanding of the risks and benefits of hormone replacement therapy (HRT). How women and providers will react to these findings is unknown. Surprisingly little is known about how to help women successfully discontinue HRT. Our primary aims are to: 1) Use qualitative methods (interviews, focus groups) to identify new salient domains surrounding shared decision making about HRT for women and providers post WHI, with an emphasis on HRT discontinuation; 2) Using the findings from interviews and focus groups, develop and conduct surveys of women and providers to describe their experiences with successful or attempted HRT discontinuation post WHI, and determine who tries to quit, who succeeds, and what approaches are most likely to lead to successful HRT discontinuation; 3) Use surveys to; a) describe knowledge, attitudes, beliefs, and practices related to HRT decision making post-WHI; b) compare responses to those from surveys conducted before the release of the WHI; c) describe regional variations in responses; and 4) Describe temporal trends in rates of HRT initiation and discontinuation, 1995-2005, to evaluate the impact of the release of findings from the WHI and other HRT trials. The study will be conducted at Group Health Cooperative and Harvard Pilgrim Health Care. To accomplished these aims we will: 1) Conduct in depth telephone interviews about HRT, among women aged 45 to 60 years, and health care providers; 2) Conduct focus groups among women aged 45 to 60 years, and health care providers; 3) Analyze interview and focus group data to design surveys that capture the salient issues around HRT decision making, continuation and discontinuation; 4) Conduct telephone surveys of women, aged 45-70 years, to describe experiences with successful and unsuccessful HRT discontinuation, and ascertain HRT knowledge, attitudes, beliefs, and behaviors; 5) Conduct surveys of health care providers, to ascertain knowledge, attitudes, beliefs, and prescribing practices regarding HRT, and strategies used to help women discontinue HRT; 6) Examine temporal trends in women's and providers attitudes and beliefs about HRT, by comparing new survey data to surveys conducted between 1995 and 1999; 7) Use automated pharmacy data to describe the prevalence and incidence rates of HRT use over the 11-year period from 1995-2005. This study will provide key information about HRT decision making, and experiences with HRT discontinuation, in an era of increased scientific clarity about HRT's risks and benefits.

描述（由申请人提供）：妇女健康倡议改变了我们对激素替代疗法（HRT）的风险和益处的理解。妇女和提供者将如何对这些发现作出反应尚不清楚。 令人惊讶的是，人们对如何帮助女性成功地停止HRT知之甚少。我们的主要目标是：（1）使用定性方法（访谈，焦点小组），以确定新的显着领域周围的共同决策有关HRT的妇女和供应商后WHI，重点是HRT停止; 2）使用访谈和焦点小组的调查结果，制定和进行妇女和提供者的调查，以描述他们在WHI后成功或尝试HRT中止的经历，并确定谁试图退出，谁成功了，什么方法最有可能导致成功的HRT中止; 3）使用调查; a）描述与WHI后HRT决策相关的知识、态度、信念和实践; B）将回答与WHI发布前进行的调查的回答进行比较; c）描述回答的区域差异;描述1995-2005年HRT开始和停止率的时间趋势，以评估WHI和其他HRT试验结果的影响。该研究将在Group Health Cooperative和哈佛朝圣者医疗保健中心进行。 为了实现这些目标，我们将：1）在45至60岁的妇女和医疗保健提供者中进行关于HRT的深入电话访谈; 2）在45至60岁的妇女和医疗保健提供者中进行焦点小组; 3）分析访谈和焦点小组数据，以设计调查，捕捉围绕HRT决策，继续和停止的突出问题; 4）对45-70岁的妇女进行电话调查，描述成功和不成功的HRT中止的经历，并确定HRT知识、态度、信念和行为; 5）对卫生保健提供者进行调查，以确定关于HRT的知识、态度、信念和处方实践，以及用于帮助妇女中止HRT的策略; 6）通过比较新的调查数据与1995年至1999年之间进行的调查，检查妇女和供应商对HRT的态度和信念的时间趋势; 7）使用自动药房数据来描述1995-2005年11年期间HRT使用的流行率和发病率。这项研究将提供有关HRT决策的关键信息，以及HRT中止的经验，在一个关于HRT风险和益处的科学清晰度不断提高的时代。

项目成果

Provider attributes associated with hormone therapy prescribing frequency.

• DOI: 10.1097/gme.0b013e318198e2fd
• 发表时间: 2009-07
• 期刊: Menopause (New York, N.Y.)
• 作者: Spangler L;Reed SD;Nekhyludov L;Grothaus LC;LaCroix AZ;Newton KM
• 通讯作者: Newton KM

Hormone therapy discontinuation: physician practices after the Women's Health Initiative.

• DOI: 10.1097/gme.0b013e3181d2ce57
• 发表时间: 2010-07
• 期刊: Menopause (New York, N.Y.)
• 作者: Newton KM;Reed SD;Grothaus LC;La Croix AZ;Nekhlyudov L;Ehrlich K;Ludman EJ
• 通讯作者: Ludman EJ

Depressive symptoms and menopausal burden in the midlife.

中年的抑郁症状和更年期负担。

• DOI: 10.1016/j.maturitas.2009.01.002
• 发表时间: 2009
• 期刊: Maturitas
• 影响因子: 4.9
• 作者: Reed,SusanD;Ludman,EvetteJ;Newton,KatherineM;Grothaus,LouisC;LaCroix,AndreaZ;Nekhlyudov,Larissa;Spangler,Leslie;Jordan,Luesa;Ehrlich,Kelly;Bush,Terry
• 通讯作者: Bush,Terry

Physicians' and women's views on hormone therapy and breast cancer risk after the WHI: a qualitative study.

WHI 后医生和女性对激素治疗和乳腺癌风险的看法：一项定性研究。

• DOI: 10.1080/03630240903158446
• 发表时间: 2009
• 期刊: Women & health
• 影响因子: 1.6
• 作者: Nekhlyudov,Larissa;Bush,Terry;Bonomi,AmyE;Ludman,EvetteJ;Newton,KatherineM
• 通讯作者: Newton,KatherineM

Self-reported changes in providers' hormone therapy prescribing and counseling practices after the Women's Health Initiative.

在妇女健康倡议之后，提供者自我报告的激素治疗处方和咨询实践发生了变化。

• DOI: 10.1089/jwh.2010.2047
• 发表时间: 2010
• 期刊: Journal of women's health (2002)
• 作者: Lakey,SusanL;Reed,SusanD;LaCroix,AndreaZ;Grothaus,Lou;Newton,KatherineM
• 通讯作者: Newton,KatherineM