Ga. Donker et al., Hormone replacement therapy: changes in frequency and type of prescriptionby Dutch GPs during the last decade of the millennium, FAM PRACT, 17(6), 2000, pp. 508-513
Objective. The present study was conducted in order to determine the change
of frequency and type of hormone replacement therapy (HRT) regimen newly p
rescribed by Dutch GPs.
Methods. A comparison was made of two data sets (multi-stage random samples
) collected in 1987/88 and from 1995 to 1998 concerning women 40 years and
older who were newly prescribed HRT.
Results. Compared with 1987/88, 50% more patients were newly prescribed HRT
in 1998 (2.0 in 1987/88 and 3.0 in 1998 per 1000 registered women, P < 0.0
1). The age distribution remained about the same, with a peak between 50 an
d 54 years in each year of registration. Unopposed oestrogens (including pl
asters) were prescribed less frequently (1.3<parts per thousand> in 1987/88
versus 0.7 parts per thousand in 1998, P < 0.001), and combinations of oes
trogen and progestogen more frequently in 1998 (0.2<parts per thousand> in
1987/88 versus 1.8 parts per thousand in 1998, Pt 0.01). Sequential therapy
was prescribed slightly more frequently than continuous therapy (65% seque
ntial therapy in 1995; 55% in 1998). The most frequent reason for starting
HRT in 1995-1998 was climacteric symptoms (89-98%), followed by osteoporosi
s prevention (16-28%) and early menopause (13-25%). Rarely were preventive
goals the only reason (6%) for prescribing HRT.
Conclusions. The number of HRT prescriptions increased by 50% over the last
decade of the millennium. The age distribution remained the same. There wa
s a tendency to shift from prescribing unopposed oestrogens to combinations
of oestrogens and progestogens. Alleviation of climacteric symptoms was th
e main reason for prescribing HRT throughout the registration period. Presc
ription of HRT for prevention of osteoporosis and/or cardiovascular disease
has so far not been adopted on a large scale by Dutch GPs.