Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, Chapel Hill, NC, USA.
University of North Carolina School of Medicine, Chapel Hill, NC, USA.
Maturitas. 2024 Aug;186:108021. doi: 10.1016/j.maturitas.2024.108021. Epub 2024 May 9.
Effective menopausal care constitutes a continuum of symptom management and optimization of medical health, including cardiovascular, bone, and mental health. Menopausal knowledge and prescribing patterns changed significantly after the publication of the Women's Health Initiative. A systematic review was conducted to address three key questions about disparities in menopausal care: 1) What differences in menopausal care are experienced by specific populations? 2) What disparities are there in access to preventive care and symptomatic treatment? 3) What interventions reduce disparities in menopause management? PubMed, PsychInfo, SCOPUS, and EMBASE were queried to identify relevant articles published in the United States between 2002 and 2023. Twenty-eight articles met the review criteria; these included quantitative and qualitative analyses. Symptomatic menopausal patients utilize a range of therapies. Racial and ethnic minorities, veterans, women living with HIV, incarcerated individuals, patients with surgical menopause, and nursing home residents represent specifically studied populations that demonstrate differences in menopausal care. Healthcare professionals may impact access to certain therapeutics, possibly driven by lack of content knowledge or implicit bias. Insurance status and geographic location may also affect menopause management or access to care. Few interventions exist to address disparities in menopausal care. There is an urgent need to understand how patients and providers make menopausal treatment decisions and intervene to mitigate health disparities in menopausal care.
有效的更年期护理构成了症状管理和优化医疗健康的连续体，包括心血管、骨骼和心理健康。《妇女健康倡议》发表后，更年期知识和处方模式发生了重大变化。进行了系统评价，以解决更年期护理差异的三个关键问题：1）特定人群经历了哪些不同的更年期护理？2）在获得预防保健和症状治疗方面存在哪些差异？3）哪些干预措施可以减少更年期管理中的差异？使用 PubMed、PsychInfo、SCOPUS 和 EMBASE 检索工具在美国 2002 年至 2023 年期间发表的相关文章，以确定符合审查标准的文章；这些文章包括定量和定性分析。有症状的更年期患者使用各种治疗方法。少数族裔、退伍军人、感染艾滋病毒的妇女、被监禁者、手术绝经患者和疗养院居民是特别研究的人群，他们在更年期护理方面存在差异。医疗保健专业人员可能会影响某些疗法的获得，这可能是由于缺乏内容知识或隐性偏见所致。保险状况和地理位置也可能影响更年期管理或获得护理的机会。几乎没有干预措施可以解决更年期护理中的差异。迫切需要了解患者和提供者如何做出更年期治疗决策，并采取干预措施来减轻更年期护理中的健康差异。
