Behavior of Women Receiving Hormone Replacement Therapy
Behavior of Women Receiving Hormone Replacement Therapy
Purpose: The effects of media coverage of the Women's Health Initiative (WHI) study on the attitudes and behavior of women regarding hormone replacement therapy (HRT) were studied.
Methods: This cross-sectional observational study took place in 12 counties in western North Carolina from 1997 to 1999. Participants were recruited from among women who participated in a previous study, which examined the effects of osteoporosis education on adherence to prevention guidelines. Women in the current study were limited to those previously reporting postmenopausal status and use of HRT. Participants were interviewed by telephone with a 41-item scripted survey. Main outcomes included primary sources of information regarding HRT, perception of the accuracy of information from various sources, and changes in HRT use.
Results: Every woman in the study ( n = 97) reported having heard about the WHI study, and 52% reported that it had affected their use of HRT. Women using estrogen alone were as likely as women using an estrogen-plus-progestin combination to have had their use affected (48% versus 59%, respectively). Women making a change after hearing about the WHI study results were significantly less likely to trust information from their physicians regarding HRT.
Conclusion: A survey of women who had received HRT found that media reports on the WHI study had a significant influence on their use of HRT.
In July 2002, Rossouw et al. published results from the Women's Health Initiative (WHI) study, concluding that the overall health risks exceed the benefits for long-term use of combined estrogen-plus-progestin hormone replacement therapy (HRT). Although the study indicated that there was a decreased risk of hip fractures and colorectal cancer while using HRT, the increased risk of breast cancer, coronary heart disease, stroke, and pulmonary embolism outweighed these benefits. At that time, the study's trial of estrogen plus progestin was halted, while the trial of estrogen alone continued. (In this article, "HRT" is used to refer to both the estrogen-plus-progestin combination therapy and the estrogen-alone therapy, unless otherwise specified.) These findings were widely publicized in the popular press. A search of the Lexis-Nexis database with the key words "hormone replacement therapy" and "Women's Health Initiative" for the month following the publication date yielded 213 stories in major newspapers and magazines. Even before the 2002 WHI study findings were reported, women faced a difficult choice in deciding whether to use HRT after menopause for disease prevention. In making this decision, women often sought information from multiple sources. For example, in a 1997 study by Newton and colleagues, 49% of women cited reading material, including magazines and newspapers, as a major source of information helping them decide whether to use HRT, while 82% cited their physician. Pharmacists were not reported as a major source of information about HRT.
Until recently, the National Osteoporosis Foundation recommended that all postmenopausal women be counseled on the benefits of HRT, and in 1995 approximately 38% of postmenopausal women in the United States used some form of HRT. Because findings from the WHI study conflicted with the perceived value of HRT at the time, we questioned the impact these findings might have had on women using HRT when the findings were first reported.
In this cross-sectional observational study, we examined the effects of media coverage of the WHI study on the attitudes and behavior of women regarding HRT. We first examined whether participants had heard of the WHI study findings and, if so, if they had altered their own use of HRT. We hypothesized that the study's findings might cause women to become more skeptical of recommendations made by their physicians or conveyed by the medical community through the mass media. We wanted to know whether women who altered their use of HRT in response to the WHI study placed less trust in the information their physicians provided about HRT.
Purpose: The effects of media coverage of the Women's Health Initiative (WHI) study on the attitudes and behavior of women regarding hormone replacement therapy (HRT) were studied.
Methods: This cross-sectional observational study took place in 12 counties in western North Carolina from 1997 to 1999. Participants were recruited from among women who participated in a previous study, which examined the effects of osteoporosis education on adherence to prevention guidelines. Women in the current study were limited to those previously reporting postmenopausal status and use of HRT. Participants were interviewed by telephone with a 41-item scripted survey. Main outcomes included primary sources of information regarding HRT, perception of the accuracy of information from various sources, and changes in HRT use.
Results: Every woman in the study ( n = 97) reported having heard about the WHI study, and 52% reported that it had affected their use of HRT. Women using estrogen alone were as likely as women using an estrogen-plus-progestin combination to have had their use affected (48% versus 59%, respectively). Women making a change after hearing about the WHI study results were significantly less likely to trust information from their physicians regarding HRT.
Conclusion: A survey of women who had received HRT found that media reports on the WHI study had a significant influence on their use of HRT.
In July 2002, Rossouw et al. published results from the Women's Health Initiative (WHI) study, concluding that the overall health risks exceed the benefits for long-term use of combined estrogen-plus-progestin hormone replacement therapy (HRT). Although the study indicated that there was a decreased risk of hip fractures and colorectal cancer while using HRT, the increased risk of breast cancer, coronary heart disease, stroke, and pulmonary embolism outweighed these benefits. At that time, the study's trial of estrogen plus progestin was halted, while the trial of estrogen alone continued. (In this article, "HRT" is used to refer to both the estrogen-plus-progestin combination therapy and the estrogen-alone therapy, unless otherwise specified.) These findings were widely publicized in the popular press. A search of the Lexis-Nexis database with the key words "hormone replacement therapy" and "Women's Health Initiative" for the month following the publication date yielded 213 stories in major newspapers and magazines. Even before the 2002 WHI study findings were reported, women faced a difficult choice in deciding whether to use HRT after menopause for disease prevention. In making this decision, women often sought information from multiple sources. For example, in a 1997 study by Newton and colleagues, 49% of women cited reading material, including magazines and newspapers, as a major source of information helping them decide whether to use HRT, while 82% cited their physician. Pharmacists were not reported as a major source of information about HRT.
Until recently, the National Osteoporosis Foundation recommended that all postmenopausal women be counseled on the benefits of HRT, and in 1995 approximately 38% of postmenopausal women in the United States used some form of HRT. Because findings from the WHI study conflicted with the perceived value of HRT at the time, we questioned the impact these findings might have had on women using HRT when the findings were first reported.
In this cross-sectional observational study, we examined the effects of media coverage of the WHI study on the attitudes and behavior of women regarding HRT. We first examined whether participants had heard of the WHI study findings and, if so, if they had altered their own use of HRT. We hypothesized that the study's findings might cause women to become more skeptical of recommendations made by their physicians or conveyed by the medical community through the mass media. We wanted to know whether women who altered their use of HRT in response to the WHI study placed less trust in the information their physicians provided about HRT.
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