A survey of obstetrician-gynecologists concerning practice patterns and attitudes toward hormone therapy

Objective: To examine the knowledge and prescribing practices of obstetrician-gynecologists regarding hormone therapy in light of the published evidence from the Women's Health Initiative study on combined estrogen+progestin. Design: A survey questionnaire was sent to 2,500 randomly selected Fellows of the American College of Obstetricians and Gynecologists in November of 2003; 705 surveys were returned. Of those, 644 reported their specialty as obstetrics and/or gynecology and those responses are reported. Results: A majority of physicians that completed their residency before 1995, both men and women, were not convinced by the WHI research results and disagreed with the decision to end the trial. Physicians that rated themselves very confident about their ability to interpret the scientific literature were more likely to be unconvinced by the results and to disagree with the decision to end the trial. In general, physicians who completed their residency more recently rated the benefits of hormone therapy lower and the risks higher. A majority of respondents (53.3%) reported that their prescribing practices were unlikely to change; however, 29.6% reported that they would be somewhat less likely and 9.5% dramatically less likely to prescribe hormone therapy. Physicians reported that their patients were less likely to request hormone therapy (91.8%) and were more likely to discontinue use (93.0%). Conclusion: Physicians who have been in practice longer were more positive about the risks and benefits of HT, and were more skeptical about the recent research. The published data seem to have affected patient preferences and to have had some effect on physician prescribing practices.