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Menopause:
doi: 10.1097/gme.0b013e318198e2fd
Articles

Provider attributes associated with hormone therapy prescribing frequency

Spangler, Leslie PhD, VMD1; Reed, Susan D. MD, MPH1,2,3,4; Nekhyludov, Larissa MD, MPH5,6; Grothaus, Louis C. MA1; LaCroix, Andrea Z. PhD1,4; Newton, Katherine M. PhD1,2

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Abstract

Objective: The aim of this study was to identify provider characteristics associated with hormone therapy prescribing.

Methods: The study design is cross-sectional. In December 2005, we mailed surveys to providers practicing in two integrated healthcare delivery systems located in the northwestern and northeastern United States; 379 responded (74%) and 249 (49% of total) granted access to their automated data. Data included provider demographics, practice characteristics, and perceptions about hormone therapy. Provider-specific annual hormone therapy prescribing frequency was calculated as days supply of hormone therapy filled divided by the number of visits (among women aged 45-80 y). Factors associated with higher rates of hormone therapy prescribing were identified using bivariate and multivariate analyses.

Results: We report results separately for primary care providers (internists and family practitioners) and obstetrician/gynecologists because significant correlates differed in these two groups. For both primary care providers and obstetrician/gynecologists, in multivariate analyses, hormone therapy prescribing varied by site (P ≤ 0.002) and years at the healthcare organization (P ≤ 0.01). For primary care providers only, higher hormone therapy prescribing was associated with reported expert knowledge of the hormone therapy trials (P ≤ 0.001). For obstetrician/gynecologists, higher hormone therapy prescription was related to feeling well prepared to counsel women on hormone therapy (P ≤ 0.007), believing that the risks of estrogen with progestogen had been exaggerated (P = 0.04), and seeing younger aged patients (P = 0.03).

Conclusions: After the release of the Women's Health Initiative findings and practicing under similar clinical guidelines, hormone therapy prescribing is associated with providers' confidence, practice location, and time with a healthcare organization.

©2009The North American Menopause Society

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