FACTORS INFLUENCING THE PRESCRIPTION OF HORMONE REPLACEMENT THERAPY

Objective: To assess the effects of age, bone mineral density, risk of cardiovascular disease, and of breast cancer on the prevalence of hor mone replacement therapy (HRT) prescriptions. Methods: Seventeen chart s of postmenopausal women were summarized. For each chart, we construc ted 36 different cases by modifying the age (two levels), the bone min eral density (three levels), the cardiovascular risk (three levels), a nd the breast cancer risk (two levels). Twelve cases of these 612 file s were sent to each Belgian gynecologist (n = 1010). Results: Overall, HRT was prescribed in 67% of the cases. It was prescribed in 54.6% of women who had a normal bone mass, 67.9% of women with a low bone mass , and 79.0% of those with osteoporosis (P < .001). The prescription ra te was higher in younger women (mean +/- standard deviation 55 +/- 4 y ears) than in their peers who were 10 years older (79.3% versus 55.2%; p < .001). No significant variation was observed in relation to the c ardiovascular risk profile or to breast cancer risk. Conclusion: Osteo porosis is associated with an increased rate and older age with a decr eased rate of HRT prescription, whereas no difference is observed in a ssociation with cardiovascular or breast cancer risk. (C) 1997 by The American College of Obstetricians and Gynecologists.