Department of Biomedical and Clinical Sciences, Linköping University, 581 83 Linköping, Sweden; Department of Obstetrics and Gynaecology, Kalmar, County Hospital, 391 85 Kalmar, Sweden.
Department of Biomedical and Clinical Sciences, Linköping University, 581 83 Linköping, Sweden; School of Medical Sciences, Faculty of Medicine and Health, Örebro University, 701 82 Örebro, Sweden; Department of Obstetrics and Gynecology, Faculty of Medicine and Health, Örebro University, 701 85 Örebro, Sweden.
Maturitas. 2023 Sep;175:107787. doi: 10.1016/j.maturitas.2023.107787. Epub 2023 Jun 13.
To describe the trends in the prevalence of use menopausal hormone therapy (MHT) in Sweden over the period 2000-2021 and to analyse the impact of different lengths of run-in on the calculated incident use.
Individual-level data on MHT dispensations for 2.5 million women aged 45-69 years for the period 2006-2021 were analysed. Aggregated sales volumes in defined daily dose (DDD) were available for the whole study period (2000-2021).
One-year prevalence and one-year incidence (18-month run-in) per 1000 women and DDD per 1000 women per day of MHT were the main outcome measures. The predictive values for incidence representing first-ever use of MHT were calculated for different run-in periods, which is a defined period without dispensations.
Both the DDD, from 2000, and the prevalence, from 2006, decreased by over 80 % in women aged 50-54 years, until 2010, when the use of MHT stabilised. The predictive value for incident users to be first-ever users was 88 % in women aged 50-54 years, with a run-in of 18 months, in 2021. The incidence was stable between 2007 and 2016. From 2017 the incidence increased, being most pronounced for women close to menopause.
MHT use decreased significantly after the turn of the century, but has increased since 2017. A run-in period of 18 months was found suitable and reliable for defining incident users of MHT in the age intervals closest to menopause. Incidence seems to be a more sensitive measure than prevalence or DDD for the early detection of changes in trends in prescriptions of MHT.
描述 2000 年至 2021 年期间瑞典使用绝经激素治疗（MHT）的流行趋势，并分析不同的引入期对计算出的新使用情况的影响。
对 250 万名年龄在 45-69 岁的女性在 2006 年至 2021 年期间的 MHT 配药的个体水平数据进行了分析。在整个研究期间（2000-2021 年），都可获得按定义日剂量（DDD）计算的汇总销售量。
每 1000 名妇女的一年流行率和一年发生率（18 个月引入期）以及每 1000 名妇女每日 MHT 的 DDD 为主要观察指标。计算了不同引入期（即无配药的定义期）的首次使用 MHT 的发生率的预测值。
50-54 岁女性的 MHT 的 DDD（始于 2000 年）和流行率（始于 2006 年）均下降了 80%以上，直到 2010 年 MHT 的使用才稳定下来。2021 年，引入期为 18 个月时，50-54 岁女性首次使用 MHT 的预测值为 88%。2007 年至 2016 年期间，发病率保持稳定。自 2017 年以来，发病率增加，接近绝经的女性最为明显。
MHT 的使用在世纪之交后显著下降，但自 2017 年以来有所增加。引入期为 18 个月，对于定义接近绝经年龄的 MHT 新使用者是合适且可靠的。与流行率或 DDD 相比，发病率似乎是检测 MHT 处方趋势变化的更敏感指标。
