Document Detail


Physician specialty is significantly associated with hormone replacement therapy use.
MedLine Citation:
PMID:  12517655     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To compare the characteristics of postmenopausal women seen by gynecologists versus family physicians and to determine factors associated with current hormone replacement therapy (HRT) use. METHODS: We conducted a cross-sectional study of 426 postmenopausal women seen for their annual examination at university clinics. Logistic regression was used to identify predictors of current versus never HRT use. RESULTS: Overall, 60% of women recruited in family practice clinics and 69% in gynecology clinics were current HRT users. Significant, positive, multivariable predictors of HRT use were gynecology versus family practice clinic attendance (odds ratio [OR] 2.6, 95% confidence interval [CI] 1.4, 4.6), surgical menopause (OR 2.3, 95% CI 1.2, 4.6), history of depression (OR 2.3, 95% CI 1.2, 4.7), at least two live births (OR 2.1, 95% CI 1.1, 4.0), and current alcohol use (OR 1.8, 95% CI 1.04, 3.2). Significant, negative, multivariable predictors were increasing age (60-70 years versus less than 60 years, OR 0.4, 95% CI 0.2, 0.8; 70 years or older versus less than 60 years, OR 0.4, 95% CI 0.2, 0.9) and history of breast cancer (OR 0.04, 95% CI 0.01, 0.14). Sociodemographic factors, smoking status, number of self-reported medical conditions, number of prescription medications besides HRT, oral contraceptive use, history of hypertension, and exercise level were tested as covariates and did not enter the model. CONCLUSION: Although current HRT use rates between clinics were similar and higher than national averages, we found that the adjusted odds of current HRT use among women receiving care from gynecologists was 2.6 times that among women receiving care from family physicians. This practice variation may reflect physicians' uncertainty surrounding the preventive value of HRT.
Authors:
Barcey T Levy; Justine M Ritchie; Elaine Smith; Teresa Gray; Wei Zhang
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  101     ISSN:  0029-7844     ISO Abbreviation:  Obstet Gynecol     Publication Date:  2003 Jan 
Date Detail:
Created Date:  2003-01-08     Completed Date:  2003-01-28     Revised Date:  2009-10-26    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  114-22     Citation Subset:  AIM; IM    
Affiliation:
Department of Family Medicine, College of Medicine, University of Iowa, Iowa City, Iowa 52242, USA. barcey-levy@uiowa.edu
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MeSH Terms
Descriptor/Qualifier:
Cross-Sectional Studies
Estrogen Replacement Therapy / utilization*
Family Practice
Female
Gynecology
Humans
Middle Aged
Physician's Practice Patterns*
Socioeconomic Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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