Physician counseling on hormone replacement therapy and bone loss: do socioeconomic and racial characteristics of women influence counseling? J Womens Health (Larchmt) 2003 Jun;12(5):495-504
Date
07/19/2003Pubmed ID
12869297DOI
10.1089/154099903766651621Scopus ID
2-s2.0-0037960940 (requires institutional sign-in at Scopus site) 3 CitationsAbstract
BACKGROUND: Although women consider multiple issues when deciding to take hormone replacement therapy (HRT), both women's use and physician counseling about HRT are strongly associated with sociodemographic factors. As prevention of bone loss is the best established long-term benefit of HRT, we sought to determine (1) if counseling about bone loss is included in discussions of HRT and (2) if sociodemographic factors affect the preventive content of HRT counseling.
METHODS: We evaluated reports of counseling on estrogen and bone loss from 1404 women aged 40-60 who reported any counseling on HRT in the 1994 National Health Interview Survey (NHIS). We also examined the association between these reports and sociodemographic factors, adjusting for clinical history, physician specialty, and physician visits.
RESULTS: We found that 80% of the women reported counseling on the effects of estrogen on bone loss. After adjustment, high school graduates (adjusted odds ratio [AOR] 1.68, confidence interval [CI] 1.02, 2.77) and college graduates (AOR 2.45, CI 1.33, 4.52) were much more likely to be counseled than women without a high school diploma. Black women were less likely to be counseled about bone loss (AOR 0.55, CI 0.33, 0.93). Although general health and menopausal symptoms were strongly associated with counseling on HRT and bone loss, neither of the osteoporosis risk factors of low body mass index (BMI) and smoking influenced counseling.
CONCLUSIONS: Most patients who discussed HRT with their providers discussed the effects of HRT on bone loss. For those who did not, several sociodemographic factors associated with any counseling on HRT are also associated with the content of HRT counseling. Understanding and addressing counseling inequities could reduce the effect of such factors on osteoporosis assessment and treatment.
Author List
Neuner JM, McCarthy EP, Davis RB, Phillips RSAuthor
Joan Neuner MD, MPH Professor in the Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdultCounseling
Estrogen Replacement Therapy
Female
Health Care Surveys
Health Services Accessibility
Humans
Insurance Coverage
Interviews as Topic
Menopause
Middle Aged
Osteoporosis, Postmenopausal
Patient Acceptance of Health Care
Physician-Patient Relations
Practice Patterns, Physicians'
Socioeconomic Factors
United States
