| アブストラクト | OBJECTIVE: To describe the long-term trends in hormone therapy (HT) use in UK general practice after evidence of associated increased risks of cardiovascular disease (CVD) and breast cancer, subsequent guideline changes in 2003/2004 advising individualized HT prescribing, and halving of HT use between 2002 and 2005. METHODS: We conducted a descriptive study to quantify annual proportions of overall and new HT use in women aged 40 to 79 years, using the UK-based Clinical Practice Research Datalink (1996-2015). We further described HT utilization patterns (drug type, administration route, dose) within 2-year blocks overall and within subpopulations with pre-existing CVD or breast cancer. RESULTS: Overall HT use continued to decline from 9.4% in 2006 to 7.5% in 2015. Between 1998 and 2001, the proportion of HT initiation was around 1.7%, which halved by 2005 (0.8%), and increased again up until 2015 (1.0%). The mean age of HT users increased from 54.7 in 1996/1997 to 56.6 in 2002/2003, and leveled off at 57 to 58 years in 2014/2015. The prevalence of CVD in HT users decreased from a peak of 5.8% in 2002/2003 to 4.5% in 2014/2015, whereas breast cancer prevalence continuously increased from 0.9% in 1996/1997 to 1.9% in 2014/2015. Overall, we observed trends towards use of estrogen therapy, vaginal HT, and lower HT dose after 2002/2003, which were stronger among subpopulations with pre-existing CVD or breast cancer. CONCLUSION: Our study suggests that the HT guideline changes implemented in UK clinical practice resulted in safer HT use, particularly in women with pre-existing CVD or breast cancer. |
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| ジャーナル名 | Menopause (New York, N.Y.) |
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| Pubmed追加日 | 2019/3/20 |
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| 投稿者 | Burkard, Theresa; Moser, Manon; Rauch, Marlene; Jick, Susan S; Meier, Christoph R |
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| 組織名 | Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacy and Epidemiology,;Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland.;Hospital Pharmacy, University Hospital Basel, Basel, Switzerland.;Boston Collaborative Drug Surveillance Program, Lexington, MA.;Boston University School of Public Health, Boston, MA. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/30889086/ |
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