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Effect of the Women’s Health Initiative on women’s decisions to discontinue postmenopausal hormone therapy

OBJECTIVE: To examine whether women who were using postmenopausal hormone therapy (HT) before publication of Women’s Health Initiative findings about risks associated with HT had been informed about the findings once published; and to estimate how knowledge of these findings was associated with their decision to discontinue HT. METHODS: We performed a telephone survey of 670 female members of a large health maintenance organization, aged 50-69 yr, who had regularly used HT from July 1, 2001, through June 30, 2002. RESULTS: Most women (93%) reported hearing about the new findings; however, only 57% considered the quality of this information to be good, regardless of its source: mass media (21%), the health plan (32%), or a health care practitioner (34%). Women’s knowledge of Women’s Health Initiative findings was generally poor; 64% did not know what the findings were, 7% were unsure of their knowledge, 6% had incorrect knowledge, and 23% had correct knowledge of Women’s Health Initiative findings. On a simple, five-question, true-or-false quiz about HT risks, 30% of respondents answered four to five questions correctly. Although not well informed, 56% reported attempting to discontinue HT in the 6 to 8 months after July 2002. Our multivariable model included five statistically significant predictors of attempting to stop HT: having been sent a letter about Women’s Health Initiative findings (odds ratio [OR] 2.7; 95% confidence interval [CI] 1.8, 3.9), reporting good-quality information from media (OR 2.1; 95% CI 1.3, 3.3), having started HT for health promotion (OR 2.0; 95% CI 1.2, 3.3), using a lower-than-standard dosage of estrogen (OR 1.9; 95% CI 1.1, 3.1), and correctly answering four or more items on the HT quiz (OR 1.9; 95% CI 1.2, 2.8). CONCLUSION: During the 6-8 months after publication of Women’s Health Initiative trial findings, most regular postmenopausal HT users tried to stop using HT, despite not being well informed about the Women’s Health Initiative findings.

Authors: Ettinger B; Grady D; Tosteson AN; Pressman A; Macer JL

Obstet Gynecol. 2003 Dec;102(6):1225-32.

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