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Ethnic differences in hormone replacement prescribing patterns

Journal of General Internal Medicine volume 14, pages 663–669 (1999)Cite this article

Abstract

OBJECTIVE: To determine whether prescription patterns of hormone replacement therapy (HRT) differ in African-American, Asian, Latina, Soviet immigrant, and white women.

DESIGN: Retrospective review of computerized medical records.

SETTING: The general internal medicine, family medicine, and gynecology practices of an academic medical center.

PATIENTS: Women aged 50 years or older with at least one outpatient visit from January 1, 1992, to November 30, 1995.

MEASUREMENTS AND MAIN RESULTS: Use of HRT was defined as documentation of systemic estrogen use. The main predictor variable was self-identified ethnicity. Age, diagnosis (coronary heart disease, hypertension, diabetes, osteoporosis, or breast cancer), and median income were included in the analysis. Of the 8,968 women (mean age, 65.4 years) included, 50% were white, 20% Asian, 15% African American, 9% Latina, and 6% Soviet immigrants. Whites (33%) were significantly more likely to be prescribed HRT than Asians (21%), African Americans (25%), Latinas (23%), or Soviet immigrants (6.6%), p<0.01 for each. Multivariate analysis, comparing ethnic groups and controlling for confounding variables, showed that Asians (odds ratio [OR] 0.56; 95% confidence interval [CI] 0.49, 0.64), African Americans (OR 0.70; 95% CI 0.60, 0.81), Latinas (OR 0.70; 95% CI 0.58, 0.84), and Soviet immigrants (OR 0.14; 95% CI 0.10, 0.20) were each less likely to be prescribed HRT than were white women. Although women with osteoporosis were more likely to receive HRT (OR 2.28; 95% CI 1.71, 2.99), those with coronary heart disease were not (OR 0.88; 95% CI 0.68, 1.09).

CONCLUSIONS: Physicians at this medical center were more likely to prescribe HRT for white women and women with osteoporosis. Further study is needed to address whether these differences in HRT prescribing result in different health outcomes.

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Authors and Affiliations

  1. Received from the Medical Effectiveness Research Center for Diverse Populations, University of California, San Francisco, Calif.

    Arleen F. Brown MD,  Eliseo J. Pérez-Stable MD, Eric E. Whitaker MD, MPH, Samuel F. Posner PhD, Mark Alexander PhD, Julia Gathe MD & A. Eugene Washington MD, MSc

  2. the Center for Aging in Diverse Communities, University of California, San Francisco, Calif.

    Eliseo J. Pérez-Stable MD, Mark Alexander PhD & A. Eugene Washington MD, MSc

  3. the Division of General Internal Medicine in the Department of Medicine, University of California, San Francisco, Calif.

    Arleen F. Brown MD & Eric E. Whitaker MD, MPH

  4. the Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, Calif.

    Samuel F. Posner PhD, Mark Alexander PhD, Julia Gathe MD & A. Eugene Washington MD, MSc

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  1. Arleen F. Brown MD
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  2. Eliseo J. Pérez-Stable MD
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Additional information

This project was supported by grant HS07373-01 from the Agency for Health Care Policy and Research and by grant 1P30 AG15272 awarded by the National Institute on Aging, the National Institute of Nursing Research, and the Office of Research on Minority Health.

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Brown, A.F., Pérez-Stable, E.J., Whitaker, E.E. et al. Ethnic differences in hormone replacement prescribing patterns. J GEN INTERN MED 14, 663–669 (1999). https://doi.org/10.1046/j.1525-1497.1999.10118.x

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  • DOI: https://doi.org/10.1046/j.1525-1497.1999.10118.x

Key Words

  • hormone replacement therapy
  • postmenopausal women
  • ethnicity
  • physician prescribing
  • prevention