Document Detail


Prescribing of hormone therapy for menopause, tibolone, and bisphosphonates in women in the UK between 1991 and 2005.
MedLine Citation:
PMID:  17598097     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The purpose of this study was to examine recent trends in the prescribing of hormone therapy for menopause, tibolone, and bisphosphonate preparations for the prevention or treatment of osteoporosis, in the UK in relation to publication of research evidence on the health effects of hormone therapy and subsequent changes in prescribing advice. METHODS: Individual patient-level data were obtained on the prescribing of hormone therapy, tibolone, and bisphosphonates by general practitioners in the UK between 1991 and 2005 to women aged 40 years and older in the UK General Practice Research Database. Overall and age-specific prescribing prevalence were calculated for each therapy type. Prescribing prevalence was also calculated for subcategories of hormone therapy and bisphosphonates. RESULTS: Prescribing of hormone therapy to women aged 40 years and older increased between 1991 and 1996 and remained fairly stable between 1997 and 2001. Hormone therapy prescribing has fallen by about 50% since 2002. Tibolone, a selective tissue estrogenic activity regulator, is prescribed much less commonly than hormone therapy but shows a similar pattern. Prescribing of bisphosphonates increased rapidly throughout the study period, particularly in women aged 70 years and older, with the pattern of prescribing reflecting to some extent, the availability of new weekly formulations. CONCLUSIONS: Trends in the prescribing of hormone therapy in the UK appear to closely reflect new epidemiological evidence and prescribing advice. It is likely that the substantial fall in hormone therapy and tibolone prescribing seen since 2002 is a direct consequence of the publication of Women's Health Initiative trial results and subsequent changes in advice given by the Committee on Safety of Medicines. The 1997 publication of results from the Collaborative Group on Hormonal Factors in Breast Cancer and 2003 publication of the Million Women Study findings may also have impacted on trends, particularly within certain age groups. The substantial and continuing increase in prescribing prevalence of bisphosphonates reinforces the need for research into the long-term risks and benefits of these therapies.
Authors:
Joanna Watson; Lesley Wise; Jane Green
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Publication Detail:
Type:  Journal Article     Date:  2007-06-28
Journal Detail:
Title:  European journal of clinical pharmacology     Volume:  63     ISSN:  0031-6970     ISO Abbreviation:  Eur. J. Clin. Pharmacol.     Publication Date:  2007 Sep 
Date Detail:
Created Date:  2007-08-09     Completed Date:  2008-01-03     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  1256165     Medline TA:  Eur J Clin Pharmacol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  843-9     Citation Subset:  IM    
Affiliation:
Cancer Research UK Epidemiology Unit, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford, OX3 7LF, UK. joanna.watson@ceu.ox.ac.uk
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Bone Density Conservation Agents / pharmacology,  therapeutic use
Data Collection / methods
Diphosphonates / pharmacology,  therapeutic use*
Drug Prescriptions / statistics & numerical data*
Estrogen Replacement Therapy / methods,  statistics & numerical data
Female
Great Britain
Humans
Menopause / drug effects*,  physiology
Middle Aged
Norpregnenes / pharmacology,  therapeutic use*
Osteoporosis, Postmenopausal / drug therapy,  prevention & control
Physician's Practice Patterns / statistics & numerical data*,  trends
Reproducibility of Results
Risk Assessment / methods,  statistics & numerical data
Time Factors
Chemical
Reg. No./Substance:
0/Bone Density Conservation Agents; 0/Diphosphonates; 0/Norpregnenes; 5630-53-5/tibolone

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