- 作者：Jr. ; Felipe Lazar ; Lucia Costa-Paiva ; Sirlei S. Morais ; Adriana Orcesi Pedro ; Aarã ; o Mendes Pinto-Neto
- 关键词：Women's Health Initiative ; Hormone therapy ; Post-WHI ; Knowledge– ; attitude– ; practice ; Menopause ; Postmenopausal women
- 刊名：Maturitas
- 出版年：2007
- 期刊代码：192_03785122
- 类别：med
- 出版时间：20 February 2007
- 卷：56
- 期：2
- 页码：129-141
- 文件大小：349 K
The objective of this study was to evaluate gynecologists’ knowledge of the WHI study, and its repercussions on their attitudes and practice 3 years after publication.
Design
A self-administered, anonymous questionnaire containing 19 questions was sent to 6000 gynecologists, members of the São Paulo Society of Obstetrics and Gynecology.
Results
The response rate was 24.2%(1453 completed questionnaires) with a sample error of 2.23%and confidence level of 95%. Although 95.9%of the respondents were aware of the WHI study, only 24.4%knew of all the other studies mentioned (HERS I, HERS II and Million Women Study). Although 84.6%stated that the results of the WHI study could not be extrapolated to other forms of HT, 23.1%and 25.2%, respectively, stopped prescribing CEE or MPA, 63.7%decreased the dose, 55.2%opted for drugs such as bisphosphonates, tibolone and SERMS, and 46.3%began to prescribe tranquilizers, isoflavone and other natural medications. Moreover, 59.2%agreed that HT should be used for only 4–5 years. Prescriptions decreased significantly for all indications (p < 0.0001). The principal reason for physicians to discontinue HT in a patient was increased risk of breast cancer (62.3%), whereas, according to the physicians, the most important factor for the patients was fear of HT (80.3%).
Conclusion
A high percentage of gynecologists in this study knew of the WHI study and followed its recommendations concerning cardiovascular prevention; consequently they changed their management of the treatment of postmenopausal women by restricting indications for HT and decreasing its duration of use and dose.