Conklin Danette, Ramakrishnan Akshaya, Yu Luchen, Varghese Sharon, Sajatovic Martha, Loue Sana, MacPhedran Sally
Department of Psychiatry and of Reproductive Biology, University Hospitals Cleveland Medical Center, Cleveland, OH, USA.
Psychiatry and Reproductive Biology, Case Western Reserve University, Cleveland, United States.
J Racial Ethn Health Disparities. 2024 Dec 13. doi: 10.1007/s40615-024-02209-4.
Menopause hormone therapy has improved the quality of life for perimenopausal and early postmenopausal women, yet women may not be prescribed or use this treatment option. The purpose of this study was to conduct a scoping review to assess whether health disparities existed in hormone therapy prescription rates and use for peri- and postmenopausal care based on demographic and clinical characteristics in real-world, observational studies conducted in the USA.
A chief librarian conducted a search strategy from 1940 to 10/31/2023 in five bibliographic databases. One hundred eighty-four articles were found through database and handsearching. After removing duplicates and excluding articles that did not meet study criteria, 14 articles were included in this review. Data were independently extracted and charted using a data extraction form, which was developed based on the study aims. Reviewers met to confirm agreement and discuss disagreements.
Sixteen health disparities, in menopause hormone therapy prescribing or use, were found in this scoping review. Differences between ethnic groups were found in 9 of 14 articles. Education level, menopause route, medical conditions, and practitioner specialization were in 4 of the 14 articles. The remaining 11 health disparities were categorized under chronic medical conditions and social constructs.
Health disparities have existed for decades in menopause hormone therapy prescribing and use for peri- and postmenopausal women. Identification of health disparities for underserved groups can help reshape educational initiatives for practitioners in all relevant disciplines.
绝经激素治疗改善了围绝经期和绝经后早期女性的生活质量,但女性可能未被开具或使用这种治疗方案。本研究的目的是进行一项范围综述,以评估在美国开展的真实世界观察性研究中,基于人口统计学和临床特征,激素治疗在围绝经期和绝经后护理中的处方率和使用情况是否存在健康差异。
一位主任馆员在五个文献数据库中进行了从1940年至2023年10月31日的检索策略。通过数据库检索和手工检索共找到184篇文章。在去除重复项并排除不符合研究标准的文章后,本综述纳入了14篇文章。使用基于研究目的开发的数据提取表独立提取数据并绘制图表。评审人员开会确认一致性并讨论分歧。
在本范围综述中发现了16项绝经激素治疗处方或使用方面的健康差异。14篇文章中有9篇发现了种族群体之间的差异。教育水平、绝经途径、医疗状况和从业者专业在14篇文章中有4篇提及。其余11项健康差异归类于慢性疾病和社会结构因素。
绝经激素治疗在围绝经期和绝经后女性的处方和使用方面存在健康差异已达数十年。识别服务不足群体的健康差异有助于重塑所有相关学科从业者的教育举措。