Trust In Doctor Means Women Remain On Hormone Replacement Therapy

1-23-98
Hershey Pa. -- - New research shows that women who have a long-term relationship with their physician stay on their estrogen medication at a much higher rate than the national average.

"For women who needed hormone replacement therapy (HRT), we found that 89 percent stayed on the therapy for one year, and 82 percent were on the therapy a full five years after they began taking the medication. Most national averages are only about 30 percent," says David Halbert, M.D., associate professor of obstetrics and gynecology at Penn State's College of Medicine.

All of the 214 patients in the study were active patients of a single practitioner, Dr. Halbert, also a physician with the Penn State Geisinger Health System. All patients were born on or before 1945, and all indicated average height, weight, education and exercise patterns for middle class, suburban, postmenopausal population He says the main reason women started on HRT was to relieve symptoms from menopause such as hot flashes, mood swings and night sweats.

Tom Lloyd, Ph.D., professor of obstetrics and gynecology and a co-investigator, says often patients stop taking HRT because of side effects such as vaginal bleeding and weight gain.

Lloyd says, "Dr. Halbert was able to work closely with each patient when the problem of side effects would occur. If they would need an adjustment to their medication, he would make the change and reassure them. This trust contributed greatly to compliance." Lloyd also believes these are among the highest continuing usage rates that have ever been reported.

The paper titled, "Hormone Replacement Therapy Usage: A Ten Year Experience of a Solo Practitioner," was published in the January issue of the journal, Maturitas, Journal of the Climacteric & Postmenopause.

According to Halbert, the use of HRT to reduce the risk of major health disorders in later life is a significant medical and public health issue. He says several forms of HRT are recognized to improve quality of life, reduce the risk of osteoporosis and cardiovascular disease, and may also put off the onset of Alzheimer's disease.

"About 38 percent of women will die from heart attack. About half of those can be prevented with estrogen therapy. That means out of every five women who will have a heart attack, one could be avoided if a women stays on HRT. The long-term benefits can't be overemphasized, and that is something I try and tell my patients," adds Halbert.

Lloyd also believes this study points to the importance of establishing a long-term relationship with one physician. He says ultimately that will translate into all patients, not just those on HRT, being healthier because they will trust a physician's advice and stay on their medication.

The study was funded by a General Clinical Research Center incentive grant from Penn State's College of Medicine.

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Contacts:
Leilyn Perri (717) 531-8604 (o) leilyn.perri@hmc.psu.edu
M. Steven Bortner (717) 531-8607 (o) (717) 838-5910 (h)