Dramatic change in prescribing of hormone replacement therapy in the Netherlands after publication of the Million Women Study: a follow-up study
Dramatic change in prescribing of hormone replacement therapy in the Netherlands after publication of the Million Women Study: a follow-up study
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DOI：
10.1111/j.1365-2125.2005.02502.x
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发表时间：
2005-12-01
影响因子：
3.4
通讯作者：
de Jong-van den Berg, LTW
中科院分区：
文献类型：
--
作者：
Faber, A;Bouvy, ML;de Jong-van den Berg, LTW
旨在评估荷兰关于绝经后激素替代疗法(HRT)新的安全信息在处方实践中的传播情况，并评估修订后的指南对HRT长期治疗的影响。设计横断面研究.建立荷兰北部和东部约45万名患者的社区药房配药数据。2000年1月1日至2004年1月1日期间，45-69岁的妇女至少分配了一张HRT处方。主要衡量HRT的年和季度患病率以及新HRT使用者的比例，结果激素替代疗法的使用率从2000年的107/1000[95%可信区间(CI)104,110]下降到2003年的87/1000(95%可信区间84，)。患病率的下降在年轻年龄组中尤为明显，在雌激素/孕激素组合的使用者中最为明显。妇女健康倡议研究(WHI)发表后，HRT处方的处方略有减少，而HRT处方在2003年8月发表《百万妇女研究报告》(MWS)后急剧下降。在2002年第四季持续使用HRT的人士中，55%的人使用HRT超过3年。这一比例在2003年第四季度为53。结论与WHI研究结果的发布相反，在荷兰，MWS发表后，HRT处方大幅下降。尽管新的建议认为应不鼓励长期使用HRT，但在MWS公布后，长期使用HRT的比例没有变化。
Aims To estimate the diffusion of new safety information concerning postmenopausal hormonal replacement therapy (HRT) into prescribing practice in the Netherlands and to assess the impact of revised guidelines on the long-term treatment of HRT.Design Cross-sectional study.Setting Community pharmacy dispensing data from a population of approximately 450 000 patients in the northern and eastern part of the Netherlands.Population Women aged 45-69 years to whom at least one HRT prescription was dispensed between 1 January 2000 and 1 January 2004.Main ouatcome measures Annual and quarter prevalences of HRT and the proportion of new HRT users, switchers and continuous HRT users per quarter.Results The prevalence of HRT prescribing decreased significantly from 107/1000 [95% confidence interval (CI) 104, 110] in 2000 to 87/1000 (95% CI 84, 89) in 2003. The decreasing prevalence was especially evident among the younger age groups and was most pronounced among users of oestrogen/progestagen combinations. The publication of the Women Health Initiative Study (WHI) was followed by a modest decrease in prescribing of HRT, whereas prescribing of HRT declined dramatically after publication of the Million Women Study (MWS) in August 2003. Among the continuous HRT users in the 4th quarter of 2002, 55% used HRT longer than 3 years. This percentage was 53 in the 4th quarter of 2003.Conclusions In contrast to the release of the WHI study results, publication of the MWS was followed by a dramatic fall in prescribing of HRT in the Netherlands. Despite the new recommendation that long-term HRT use should be discouraged, the proportion of long-term users did not change after the publication of the MWS.