1. The attitude of gynecologists in São Paulo, Brazil 3 years after the Women's Health Initiative study
- Author
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Lazar, Felipe, Costa-Paiva, Lucia, Morais, Sirlei S., Pedro, Adriana Orcesi, and Pinto-Neto, Aarão Mendes
- Subjects
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GYNECOLOGISTS , *SURVEYS , *WOMEN'S health , *DISEASES in women , *DIPHOSPHONATES , *HEALTH risk assessment , *HORMONE therapy complications , *PHYSICIANS' attitudes - Abstract
Abstract: Objective: The objective of this study was to evaluate gynecologists’ knowledge of the WHI study, and its repercussions on their attitudes and practice 3 years after publication. Design: A self-administered, anonymous questionnaire containing 19 questions was sent to 6000 gynecologists, members of the São Paulo Society of Obstetrics and Gynecology. Results: The response rate was 24.2% (1453 completed questionnaires) with a sample error of 2.23% and confidence level of 95%. Although 95.9% of the respondents were aware of the WHI study, only 24.4% knew of all the other studies mentioned (HERS I, HERS II and Million Women Study). Although 84.6% stated that the results of the WHI study could not be extrapolated to other forms of HT, 23.1% and 25.2%, respectively, stopped prescribing CEE or MPA, 63.7% decreased the dose, 55.2% opted for drugs such as bisphosphonates, tibolone and SERMS, and 46.3% began to prescribe tranquilizers, isoflavone and other natural medications. Moreover, 59.2% agreed that HT should be used for only 4–5 years. Prescriptions decreased significantly for all indications (p <0.0001). The principal reason for physicians to discontinue HT in a patient was increased risk of breast cancer (62.3%), whereas, according to the physicians, the most important factor for the patients was fear of HT (80.3%). Conclusion: A high percentage of gynecologists in this study knew of the WHI study and followed its recommendations concerning cardiovascular prevention; consequently they changed their management of the treatment of postmenopausal women by restricting indications for HT and decreasing its duration of use and dose. [Copyright &y& Elsevier]
- Published
- 2007
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