Fewer senior women using hormone replacement therapy



    New study shows public drug claims for hormone replacement therapy among
    female seniors down 60% in five years

    OTTAWA, June 19 /CNW Telbec/ - The use of hormone replacement therapy
(HRT) by senior Canadian women in five provinces has dropped from 14% to 5%
since the publication of the 2002 Women's Health Initiative (WHI) study, which
found the health risks of using HRT outweighed the benefits. A new analysis of
public drug claims from the Canadian Institute for Health Information (CIHI)
shows that the use of HRT among female seniors (aged 65 and older) in five
provinces declined each year between 2001-2002 and 2006-2007, with the highest
average annual rate of decline (30%) occurring in the two-year period
following the publication of the WHI study. The five provinces included in the
CIHI analysis were Alberta, Saskatchewan, Manitoba, New Brunswick and Nova
Scotia.
    "Up until the late-1990s, many women were prescribed hormone replacement
therapy because of its success in relieving the symptoms of menopause and its
reported protective benefits in coronary heart disease and osteoporosis," says
Dr. Jennifer Blake, obstetrician and gynecologist in chief at Sunnybrook
Health Sciences Centre in Toronto. "New evidence highlighting the potential
risks of HRT, as well as its lack of benefit in preventing heart disease, has
forced caregivers and patients to re-examine its use, particularly in elderly
patients. CIHI's study highlights a great example of how new information can
be used to immediately improve practices and advance patient safety."

    Declines reported in both estrogen-only and combination HRT

    The first reports of possible side effects associated with estrogen-only
hormone replacement treatment, namely an increased risk of endometrial cancer,
began to emerge in the 1970s, leading to the development of what is now known
as combination (progestin and estrogen) therapy. Later studies, such as the
2002 WHI study, identified important additional risks with the combination
therapy, such as an increased risk of coronary heart disease and stroke.
    While the use of both types of HRT decreased over the six years of the
study, the decline in the use of combination HRT among female seniors was more
pronounced than the decrease in the use of estrogen-only HRT. The vast
majority of female seniors still using HRT in 2006-2007 were on estrogen-only
regimens (84%), but rates of use varied between the five provinces included in
CIHI's study.
    In 2006-2007, after adjustment was made for age, the rate of
estrogen-only HRT use varied across the provinces from 3.1% to 5.4%, while
combination HRT use ranged from 0.5% to 1.1%.

    Women still using HRT, but at lower doses

    The CIHI analysis also looked at the dosage of estrogen being used by
female seniors. About 75% of female seniors using HRT were on oral conjugated
estrogens in doses of either 0.3 mg or 0.625 mg in 2006-2007. Of those using
the higher (0.625 mg) dose in 2000-2001 and still using HRT in 2006-2007, 37%
had switched to the lower (0.3 mg) dose.
    "Current Canadian menopause guidelines recommend that both estrogen-only
and combination HRT be taken at the lowest effective dose," says Blake. "For
some women, when taken properly and monitored closely, HRT can be helpful in
alleviating the symptoms of menopause and in guarding against osteoporosis."

    About CIHI

    The Canadian Institute for Health Information (CIHI) collects and
analyzes information on health and health care in Canada and makes it publicly
available. Canada's federal, provincial and territorial governments created
CIHI as a not-for-profit, independent organization dedicated to forging a
common approach to Canadian health information. CIHI's goal: to provide
timely, accurate and comparable information. CIHI's data and reports inform
health policies, support the effective delivery of health services and raise
awareness among Canadians of the factors that contribute to good health.

    
    The report, as well as the following figures, is available from CIHI's
    website at www.cihi.ca.

    Figure 1  Age-Standardized Rates of HRT Use Among Female Seniors on
              Public Drug Programs in Select Provinces,(*) 2000-2001(t) to
              2006-2007 (Figure 1 in the report)

    Figure 2  Percentage of Female Senior Estrogen-Only and Combination HRT
              Users on Public Drug Programs in Select Provinces,(*) by Age
              Group, 2006-2007 (Figure 5 in the report)

    Figure 3  Percentage Oral Conjugated Estrogen Use Among Female Senior
              Claimants on Public Drug Programs in Select Provinces,(*) by
              Strength, 2001-2002 to 2006-2007 (Figure 6 in the report)
    




For further information:

For further information: Media contacts: Leona Hollingsworth, (613)
241-7860 ext. 4140, Cell: (613) 612-3914, lhollingsworth@cihi.ca; Jennie
Hoekstra, (613) 241-7860 ext. 4331, Cell: (613) 725-4097, jhoekstra@cihi.ca


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