德国绝经激素治疗的处方情况：2004 年至 2016 年期间的现状和变化。

Prescribing of menopausal hormone therapy in Germany: Current status and changes between 2004 and 2016.

机构信息

Department of Clinical Epidemiology, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany.

Department of Biometry and Data Management, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany.

出版信息

Pharmacoepidemiol Drug Saf. 2021 Apr;30(4):462-471. doi: 10.1002/pds.5186. Epub 2021 Jan 11.

DOI:10.1002/pds.5186

PMID:33368726

Abstract

BACKGROUND

Prescribing of menopausal hormone therapy (MHT) declined drastically after publication of the Women's Health Initiative's (WHI) findings in 2002, but studies on longer-term trends and details of use are scarce.

METHODS

We used the German Pharmacoepidemiological Research Database (GePaRD) containing health insurance claims data from ~25 million persons. Using data from 2004-2016, we conducted cross-sectional analyses to determine the prevalence of MHT use overall and by type and route of administration in women aged 45-75. In longitudinal analyses, we assessed MHT use over 5 years and compared the patterns between different time periods.

RESULTS

From 2004 to 2016, prevalence of systemic MHT prescriptions decreased by >60% in women aged 55-65 and by >50% in women aged 50 and 70 years old. Prevalence declined for most types and routes of administration at all ages (-16% to -79%) with some exceptions, for example, local MHT (vaginal estrogen). Among 50-year-old women in 2012, 6% were already prescribed systemic MHT at age 49 and of the remaining women, 16% were newly prescribed systemic MHT before age 55. At all ages, the cumulative dose of systemic MHT prescribed over 5 years was lower in the period 2012-2016 compared to 2005-2009 (-6% to -46%).

CONCLUSIONS

For most types of MHT and all age groups, prevalence declined considerably between 2004 and 2016 in Germany. The cumulative dose per MHT user also decreased, suggesting a trend towards a shorter duration of use.

摘要

背景

2002 年妇女健康倡议（WHI）的研究结果公布后，绝经激素治疗（MHT）的处方量大幅下降，但关于长期趋势和使用细节的研究很少。

方法

我们使用了德国 Pharmacoepidemiological Research Database（GePaRD），其中包含来自约 2500 万人的健康保险索赔数据。使用 2004-2016 年的数据，我们进行了横断面分析，以确定 45-75 岁女性中总体 MHT 使用情况以及按类型和给药途径分类的 MHT 使用情况。在纵向分析中，我们评估了 5 年内 MHT 的使用情况，并比较了不同时期的使用模式。

结果

从 2004 年到 2016 年，55-65 岁女性的全身 MHT 处方率下降了 60%以上，50 岁和 70 岁女性的处方率下降了 50%以上。在所有年龄段，大多数类型和给药途径的 MHT 使用率都有所下降（-16%至-79%），但也有一些例外，例如局部 MHT（阴道雌激素）。在 2012 年的 50 岁女性中，49 岁时就已经有 6%的女性开了全身 MHT，而其余女性中有 16%在 55 岁之前新开了全身 MHT。在所有年龄段，与 2005-2009 年相比，2012-2016 年期间开给 5 年 MHT 用户的全身 MHT 累积剂量减少了（-6%至-46%）。