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妇产科医生对妇女健康倡议激素治疗试验证据的态度总体上仍然持怀疑态度。

Attitudes of obstetrician-gynecologists toward the evidence from the Women's Health Initiative hormone therapy trials remain generally skeptical.

作者信息

Power Michael L, Anderson Britta L, Schulkin Jay

机构信息

Research Department, American College of Obstetricians and Gynecologists, Washington, DC 20024, USA.

出版信息

Menopause. 2009 May-Jun;16(3):500-8. doi: 10.1097/gme.0b013e31818fc36e.

Abstract

OBJECTIVE

To examine the opinions of obstetrician-gynecologists regarding hormone therapy (HT) and the results from the Women's Health Initiative (WHI).

METHODS

Separate surveys were sent to two groups of practicing obstetrician-gynecologists: (1) respondents to a 2004-2005 survey (follow-up 1) and (2) members of the American College of Obstetricians and Gynecologists' Collaborative Ambulatory Research Network (follow-up 2 CARN). These studies complete a longitudinal study investigating obstetrician-gynecologists' opinions of the evidence from WHI.

RESULTS

Response rates were 64.5% and 58.8%, respectively. Responses from both surveys were generally consistent with the results from the 2004-2005 survey. A majority of physicians from both survey populations were skeptical of the combined HT results. Respondents were more likely to find the results of the unopposed estrogen trial convincing. Similar to the results from the 2004-2005 study, CARN physicians generally disagreed with the decision to end the WHI trials. Unlike the 2004-2005 study, there was no consistent effect of either age or year that residency was completed on physician opinions. Similar to the 2004-2005 study, physicians who considered alternative therapies as viable treatment options were more likely to report that they found the trial results convincing. The results from follow-up 2 CARN indicate that physicians in the south were most likely and physicians in the east were least likely to prescribe HT, suggesting that unmeasured sociocultural parameters might influence HT prescribing practice.

CONCLUSIONS

Obstetrician-gynecologists remain generally skeptical of the WHI results, although less so of the estrogen-only trial. The early end to the trials may have contributed to their skepticism.

摘要

目的

探讨妇产科医生对激素疗法(HT)的看法以及妇女健康倡议(WHI)的结果。

方法

分别向两组执业妇产科医生发送调查问卷:(1)2004 - 2005年调查的受访者(随访1);(2)美国妇产科医师学会门诊协作研究网络的成员(随访2,CARN)。这些研究完成了一项纵向研究,调查妇产科医生对WHI证据的看法。

结果

回复率分别为64.5%和58.8%。两项调查的回复总体上与2004 - 2005年调查的结果一致。来自两个调查群体的大多数医生对联合HT的结果持怀疑态度。受访者更有可能认为单纯雌激素试验的结果令人信服。与2004 - 2005年研究的结果相似,CARN医生普遍不同意终止WHI试验的决定。与2004 - 2005年研究不同,完成住院医师培训的年龄或年份对医生的看法没有一致的影响。与2004 - 2005年研究相似,认为替代疗法是可行治疗选择的医生更有可能报告他们认为试验结果令人信服。随访2的CARN结果表明,南方的医生最有可能、东部的医生最不可能开具HT,这表明未测量的社会文化参数可能会影响HT的处方实践。

结论

妇产科医生总体上仍然对WHI的结果持怀疑态度,尽管对单纯雌激素试验的怀疑较少。试验的提前结束可能导致了他们的怀疑态度。

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本文引用的文献

1
Factors associated with obstetrician-gynecologists' response to the Women's Health Initiative trial of combined hormone therapy.
Med Decis Making. 2008 May-Jun;28(3):411-8. doi: 10.1177/0272989X07312722. Epub 2008 May 13.
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Evolving practice patterns and attitudes toward hormone therapy of obstetrician-gynecologists.
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A survey of obstetrician-gynecologists concerning practice patterns and attitudes toward hormone therapy.
Menopause. 2006 May-Jun;13(3):434-41. doi: 10.1097/01.gme.0000185753.77704.65.
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Impact of the women's health initiative trial results on hormone replacement therapy.
Pharmacotherapy. 2004 Apr;24(4):495-9. doi: 10.1592/phco.24.5.495.33349.

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