PMID- 11576818
OWN - NLM
STAT- MEDLINE
DCOM- 20011018
LR  - 20190901
IS  - 0895-4356 (Print)
IS  - 0895-4356 (Linking)
VI  - 54
IP  - 10
DP  - 2001 Oct
TI  - Discontinuation of postmenopausal hormone therapy in a Massachusetts HMO.
PG  - 1056-64
AB  - Long-term postmenopausal hormone therapy alleviates menopausal symptoms, 
      decreases women's risk of osteoporosis and has been shown to reduce 
      cardiovascular morbidity and mortality in more than 30 observational studies. 
      However, nearly half of all women initiating hormone therapy discontinue within 
      the first year. This study was conducted to determine the rate and predictors of 
      hormone therapy discontinuation in a clinical practice setting. We identified 992 
      women aged 45-59 who began hormone therapy between 1993 and 1995 in a 
      Massachusetts health maintenance organization. Women were followed 2 years from 
      the day they filled a prescription for estrogen. 53% discontinued hormone therapy 
      by the end of the first year and one-fifth stopped after the first prescription. 
      A prescription from a gynecologist (RR = 0.82, 95% CI: 0.68, 0.99) and a 
      mammogram a year prior to initiation (RR = 0.75, 95% CI: 0.63, 0.89) were 
      associated with a lower rate of discontinuation. Women who were using monoamine 
      oxidase inhibitors (MAOI) or selective serotonin reuptake inhibitors (SSRI) 
      antidepressants 3 months prior to initiation (RR = 2.07, 95% CI: 1.26, 3.39) or 
      who had been enrolled in the health plan for less than 3 years (RR = 1.33, 95% 
      CI: 1.10, 1.62) had an increased risk of discontinuing hormone therapy. The year 
      a woman entered the cohort was also associated with a higher rate of 
      discontinuation (RR = 1.40, 95% CI: 1.14, 1.74 for 1994 and RR = 1.95, 95% CI: 
      1.52, 2.50 for 1995). The results indicate that long-term hormone therapy use is 
      uncommon in clinical practice, particularly when a woman or her physician 
      attempts to use hormone therapy as an alternative to antidepressant therapy, and 
      that the rates of discontinuation of hormone therapy were rising rapidly in the 
      mid-1990s.
FAU - Reynolds, R F
AU  - Reynolds RF
AD  - Pfizer, Inc., Safety Evaluation and Epidemiology, 235 E 42nd Street, New York, NY 
      10017, USA. robert.reynolds@pfizer.com
FAU - Walker, A M
AU  - Walker AM
FAU - Obermeyer, C M
AU  - Obermeyer CM
FAU - Rahman, O
AU  - Rahman O
FAU - Guilbert, D
AU  - Guilbert D
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - J Clin Epidemiol
JT  - Journal of clinical epidemiology
JID - 8801383
SB  - IM
MH  - Adult
MH  - *Decision Making
MH  - Female
MH  - Health Maintenance Organizations
MH  - Hormone Replacement Therapy/*statistics & numerical data
MH  - Humans
MH  - Massachusetts
MH  - Medical Records
MH  - *Menopause
MH  - Middle Aged
MH  - Surveys and Questionnaires
MH  - Treatment Refusal/*statistics & numerical data
MH  - Women's Health
EDAT- 2001/09/29 10:00
MHDA- 2001/10/19 10:01
CRDT- 2001/09/29 10:00
PHST- 2001/09/29 10:00 [pubmed]
PHST- 2001/10/19 10:01 [medline]
PHST- 2001/09/29 10:00 [entrez]
AID - S0895-4356(01)00378-X [pii]
AID - 10.1016/s0895-4356(01)00378-x [doi]
PST - ppublish
SO  - J Clin Epidemiol. 2001 Oct;54(10):1056-64. doi: 10.1016/s0895-4356(01)00378-x.