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Purpose: To survey postmenopausal women in primary care practice regarding decision-making about hormone therapy (HT) after publication of the Women’s Health Initiative results.
Methods: Questionnaires (n=133) including open-ended questions regarding women’s HT decisions were collected August through October 2003 in one family practice waiting room. Women born 1933-1952 attending for office visits were invited to participate. Questions addressed current views about HT, change in views in the prior year, personal rationale for taking or not taking HT, self-rated health status, symptom bother, and demographic variables. A coding scheme for qualitative analysis was developed. Two investigators coded the responses to each question. Chart review provided HT rates for the clinic population in the study window and the previous 2 years.
Results: Rate of HT use in the practice decreased to 26% at the time of survey from 49% during the previous two-year period. Survey respondents were predominantly white, healthy, well educated, highly symptomatic, long-term (>5years) HT users, and currently taking HT at a higher rate (36%). The predominant belief pattern was that use of HT is riskier than previously believed. Less common were confirmation of previous personal skepticism, rejection of new recommendations, and belief that HT is beneficial with apparent lack of awareness of new research findings.Of 50 women who had stopped HT in the previous year 12 had restarted. Restarters were struggling with their decision to continue or not. Some women who had quit were considering restart. A pattern of grief was articulated by some quitters. Women who had continued HT without stopping were a relatively young and healthy group, but the majority had used HT > 5 years. Expressions of concern/fear regarding their HT use were present in the responses of former users, quitters, restarters, and continuers.
Conclusions: This sample of care-seeking women remains concerned about pros and cons of HT. Future studies should account for both symptoms and chronic disease risk vs. benefit as factors in decision-making.
See more of Poster Session - Utility Theory; Health Economics; Patient & Physician Preferences; Simulation; Technology Assessment
See more of The 26th Annual Meeting of the Society for Medical Decision Making (October 17-20, 2004)