Prescription of Combined HRT in Non- Hysterectomised Women in General Practice

Authors

  • Ellen Stuart School of Medicine, Trinity College, University of Dublin, Ireland

Keywords:

Medicine

Abstract

Objective: The prescribing practice of combined hormone replacement therapy (HRT) medication in non-hysterectomised women in one Dublin general practice (GP) surgery from 1996 to 2003 was investigated in this study. The aim of the study was to explore whether Irish GP prescribing practice reflected the Irish College of General Practitioners (ICGP) guidelines from the Saffron Initiative (referenced in the Monthly Index of Medical Specialties (MIMS)) which guide the timing of prescription of combined cyclical HRT (CYHRT) versus continuous combined HRT (CCHRT) according to age. Methods: Using the GP Clinical Computer program in the practice, the number of prescriptions of combined HRT, the age of women at the time of their first prescription, the average age of prescription of CYHRT versus CCHRT and the percentage of women older or younger than the recommended ages for each type of combined HRT were calculated. Results: A total of 90 prescriptions for CYHRT were identified during the time period 1996 to 2003. The age range of the women was 40 to 57 years with an average age of prescription of 49.73 years. It was found that 24% of the prescriptions made were to women above the recommended cut-off point of 51 years. A total of 60 prescriptions for CCHRT were found for the time period 1996 to 2003. The age range of these women was 44 to 61 years with the average age of prescription being 51.33 years, of whom 32% were below 51 years. Conclusion: The age cut-off point of 51 years applied to most patients in terms of prescribing CYHRT versus CCHRT. It did not apply to all patients though and this fact is in keeping with updated ICGP guidelines from the Saffron Initiative. This emphasises the importance of evaluating each patient on an individual basis.

Author Biography

Ellen Stuart, School of Medicine, Trinity College, University of Dublin, Ireland

6th year Medicine

References

1. Wren B.G, editors. Progress in the management of the menopause. Proceeds of the 8th international congress on the menopause; London. London: The Parthenon Publishing Group;1997.
2. Ettinger B, Pressman A, Silver P. Effect of age on reasons for initiation and discontinuation of hormone replacement therapy. Menopause 2000; 7(2):135.
3. Limouzin-Lamouthe MA. What women want from hormone replacement therapy : results of an international survey. Euro J Obs Gynae Repro Biol 1996; 64(4):Suppl:S21-4.
4. Samsoie G. The role of ERT/HRT. Best Pract Res Clin Obstet Gynaecol 2002; 16(3):371-81.
5. Ettinger B, De-Kun L, Klein R. Unexpected vaginal bleeding and associated gynaecologic care in postmenopausal women using hormone replacement therapy : comparison of cyclic versus continuous combined schedules. Fertil Steril 1998; 69(5):865-69. 6. Chlebowski RT, Hendrix SL, Langer RD, Stefanick ML, et al. Influence of oestrogen plus progestin on breast cancer and mammography in healthy postmenopausal women : the women’s health initiative randomized trial. JAMA 2003; 289(24):3304-6
7. Taylor R. HRT linked to breast cancer. The Guardian Newspaper 2003 Aug 8. Available from: URL: http://www.guardian.co.uk/Archive
8. Hope S, Wager E, Rees M. Survey of british women’s views on the menopause and HRT. J Br Menopause Soc 1998; 4(1):33-6.
9. Saffron Initiative Steering Committee. The saffron report on women’s lifetime health needs. Dublin: TCGP; 1999
10. Saffron Group. Irish college of general practitioners general practice guide to the menopause. Dublin:ICGP;2000.
11. Medical Publications (Ireland) Limited. Monthly index of medical specialties. Dublin; July 2003.
12. British Medical Association and Royal Pharmaceutical Society of Great Britain. British national formulary. London; 2002.
13. Lethaby A, Farquhar C, Sarkis C, Roberts H, et al. Hormone replacement therapy in postmenopausal women : endometrial hyperplasia and irregular bleeding (Cochrane Review). In: The Cochrane Library, Issue 1, 2004. Chichester, UK: John Wiley & Sons, Ltd.
14. Fallon U, Kelleher C. Hormone replacement therapy: a survey of Irish general practicioners. IMJ 2000 Jan-Feb;93(1):10-14.
15. Beardsworth A. Future developments. In: Menopause, Update postgraduate centre series. Excerpta Medica UK. Millenium edition:59-60.
16. Medical Publications (Ireland) Limited. Monthly index of medical specialties. Dublin; May 1996.
17. Saffron Group. Irish college of general practitioners general practice guide to the menopause. Dublin:ICGP;2002.
18. National Medicines Information Centre. Hormone replacement therapy. Dublin: NIMC Bulletin 2003; 9(3): 1-4.

Downloads

Published

2004-01-01

How to Cite

Stuart, E. (2004). Prescription of Combined HRT in Non- Hysterectomised Women in General Practice. Trinity Student Medical Journal , 5(1), Page 79–84. Retrieved from https://www.tsmj.ie/index.php/tsmj/article/view/1949

Similar Articles

1 2 3 4 5 6 7 8 9 10 > >> 

You may also start an advanced similarity search for this article.