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Attitudes of obstetrician-gynecologists toward the evidence from the Women's Health Initiative hormone therapy trials remain generally skeptical

Power, Michael L. PhD; Anderson, Britta L. BA; Schulkin, Jay PhD

doi: 10.1097/gme.0b013e31818fc36e

Objective To examine the opinions of obstetrician-gynecologists regarding hormone therapy (HT) and the results from the Women's Health Initiative (WHI).

Methods Separate surveys were sent to two groups of practicing obstetrician-gynecologists: (1) respondents to a 2004-2005 survey (follow-up 1) and (2) members of the American College of Obstetricians and Gynecologists' Collaborative Ambulatory Research Network (follow-up 2 CARN). These studies complete a longitudinal study investigating obstetrician-gynecologists' opinions of the evidence from WHI.

Results Response rates were 64.5% and 58.8%, respectively. Responses from both surveys were generally consistent with the results from the 2004-2005 survey. A majority of physicians from both survey populations were skeptical of the combined HT results. Respondents were more likely to find the results of the unopposed estrogen trial convincing. Similar to the results from the 2004-2005 study, CARN physicians generally disagreed with the decision to end the WHI trials. Unlike the 2004-2005 study, there was no consistent effect of either age or year that residency was completed on physician opinions. Similar to the 2004-2005 study, physicians who considered alternative therapies as viable treatment options were more likely to report that they found the trial results convincing. The results from follow-up 2 CARN indicate that physicians in the south were most likely and physicians in the east were least likely to prescribe HT, suggesting that unmeasured sociocultural parameters might influence HT prescribing practice.

Conclusions Obstetrician-gynecologists remain generally skeptical of the WHI results, although less so of the estrogen-only trial. The early end to the trials may have contributed to their skepticism.

A significant proportion of obstetrician-gynecologists remain skeptical of the evidence from the WHI trials and critical of the decision to end the trials.

From the American College of Obstetricians and Gynecologists, Washington, DC.

Received August 3, 2008; revised and accepted September 29, 2008.

Funding/support: This work was supported under contract NO1-HO-34205 from the National Heart, Lung, and Blood Institute, with support from the Office of Women's Health Research, National Institutes of Health, Human Resources, and Services Administration, Department of Health and Human Services, and by grant no. R60 MC 05674 from the Maternal and Child Health Bureau (Title V, Social Security Act), Health Resources and Services Administration, Department of Health and Human Services.

Financial disclosure: None reported.

Address correspondence to: Michael L. Power, PhD, Research Department, American College of Obstetricians and Gynecologists, 409 12th Street SW, Washington, DC 20024. E-mail:

©2009The North American Menopause Society