OLDER WOMEN AND HORMONE REPLACEMENT THERAPY - FACTORS INFLUENCING LATE-LIFE INITIATION

OBJECTIVE: To describe factors associated with initiation of hormone r eplacement therapy (HRT) by older women, DESIGN: A cross-sectional stu dy of 671 randomly selected women aged 65 to 80 who participated in a larger telephone survey on preventive health behaviors. SETTING: A lar ge health maintenance organization (HMO) in Seattle, Washington.PARTIC IPANTS: Of the 521 women who responded (78%), 51 had begun taking HRT at age 60 or older and were identified as initiators. Women who had ne ver used HRT or past users who had begun HRT before age 60 were classi fied as noninitiators (n = 362). Current users who started HRT before age 60 (n = 108) were excluded. MEASUREMENTS: Sources included the tel ephone survey, automated HMO pharmacy data, and HMO utilization and pr ovider databases. RESULTS: Initiators were similar to noninitiators wi th respect to age, marital status, education, and health status. Initi ators were more likely to have had a hysterectomy at age 60 or later t han noninitiators. Sixty-two percent of the noninitiators said they ha d received no information about the benefits of HRT from their provide rs compared with 18% of initiators. HRT initiation was associated with belief in prevention benefits of HRT for fractures and cardiovascular disease and with reported encouragement from the physician to use HRT . CONCLUSIONS: Other than hysterectomy status, there were few sociodem ographic or health characteristics that markedly distinguished older i nitiators from noninitiators. Our findings show the importance of phys ician counseling in an older woman's decision to initiate HRT.