Beliefs about bioidentical hormone therapy: A cross-sectional survey of pharmacists

Siyam, Tasneem; Yuksel, Nesé

doi:10.1016/j.maturitas.2012.11.007

Cited by 11 publications

(3 citation statements)

References 35 publications

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“…The response rate was low but was targeted a priori to meet the desired sample size, based on previously published survey response rates in pharmacy practice research. 16 In addition, except for a slightly higher proportion of female respondents in the current survey (70% versus 60%), the sample characteristics were similar to those of the Canadian pharmacist workforce in terms of age ranges and hours of practice. 45 Because osteoporosis is more common among women than men, the beliefs of female respondents may have differed from those of their male counterparts, which may in turn have influenced the overall results.…”

Section: Discussionmentioning

confidence: 57%

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Bisphosphonates for Osteoporosis in Patients with Renal Insufficiency: Pharmacists’ Practices and Beliefs

Sadowski

Lyder²,

Yuksel

2016

CJHP

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ABSTRACTBackground: Clinicians often face challenges in deciding how to treat osteoporosis in patients with chronic kidney disease. As background to offering guidance to health care providers, it is important to understand their practices and beliefs.Objectives: To describe the practices and beliefs of pharmacists regarding use of bisphosphonates for patients with osteoporosis and chronic kidney disease.Methods: A cross-sectional survey of pharmacists working in hospitals and related health care settings was conducted. A 34-item online questionnaire was developed consisting of 4 sections: demographic characteristics, practices, beliefs, and comfort level with making decisions about osteoporosis treatment. An e-mail invitation was sent to members of the Canadian Society of Hospital Pharmacists (n = 2499) in November 2012.Results: A total of 367 pharmacists completed the survey. Most of the respondents were women (258 [70%]), had more than 10 years in practice (213 [58%]), and were providing care to 1 or more osteoporosis patients per week (212 [58%]). Over one-third (150 [41%]) stated that they would use a bisphosphonate for patients with creatinine clearance (CrCl) of 15–30 mL/min, but more than half (207 [56%]) stated that they would avoid a bisphosphonate (and recommend another medication) for patients with CrCl below 15 mL/min. Forty-eight percent (176/363) agreed that oral bisphosphonates could be used for patients with renal failure (defined as CrCl < 30 mL/min), so long as dosage adjustments are made. More than half (206/363 [57%]) believed that the adverse effects of oral bisphosphonates increase for patients with renal failure. Respondents expressed a low level of comfort in assessing and initiating osteoporosis treatment for patients with renal failure.Conclusions: Pharmacists had varying beliefs about managing osteoporosis in patients with chronic kidney disease. This study highlights the need for practice tools and targeted education addressing the use of bisphosphonates for these patients.RÉSUMÉContexte : Les cliniciens sont souvent confrontés à des défis lorsqu’ils doivent choisir un traitement contre l’ostéoporose chez les patients atteints d’insuffisance rénale chronique. Afin d’être en mesure de guider les fournisseurs de soins de santé, il importe de comprendre leurs pratiques et leurs croyances.Objectif : Offrir un portrait des pratiques et croyances des pharmaciens en ce qui a trait à l’emploi des bisphosphonates chez les insuffisants rénaux chroniques atteints d’ostéoporose.Méthodes : Une enquête transversale a été réalisée auprès de pharmaciens exerçant en établissements de santé. Un questionnaire en ligne a été élaboré. Il contenait 34 éléments répartis en 4 sections, soit : les caractéristiques démographiques; les pratiques; les croyances; et le degré d’aisance en ce qui a trait au choix d’un traitement contre l’ostéoporose. Un courriel d’invitation a été envoyé aux membres de la Société canadienne des pharmaciens d’hôpitaux (n = 2499) en novembre 2012.Résultats : Au total, 367 pharmaciens ont participé au sondage. La plupart des répondants étaient des femmes (258 [70 %]), possédaient plus de 10 années de pratique (213 [58 %]) et fournissaient hebdomadairement des soins à au moins un patient ostéoporotique (212 [58 %]). Plus d’un tiers (150 [41 %]) ont indiqué qu’ils emploieraient un bisphosphonate chez les patients affichant une clairance de la créatinine (ClCr) entre 15 et 30 mL/min, mais plus de la moitié (207 [56 %]) ont affirmé qu’ils n’en utiliseraient pas (et qu’ils recommandaient un autre médicament) chez les patients présentant une ClCr en deçà de 15 mL/min. Quarante-huit pour cent (176/363) ont affirmé que les bisphosphonates oraux pouvaient être employés pour les patients présentant une insuffisance rénale (définie comme une ClCr < 30 mL/min), pourvu que l’on procède à des ajustements posologiques. Plus de la moitié (206/363 [57 %]) croyaient que les effets indésirables des bisphosphonates oraux sont plus importants chez les patients souffrant d’insuffisance rénale. Les répondants ont indiqué être peu à l’aise lorsque vient le temps d’évaluer et d’amorcer un traitement contre l’ostéoporose chez les insuffisants rénaux.Conclusions : Les pharmaciens adhéraient à diverses croyances en ce qui touche la prise en charge de l’ostéoporose chez les insuffisants rénaux. La présente étude met en évidence le besoin d’outils pour la pratique ainsi que d’enseignement ciblé portant sur l’emploi des bisphosphonates chez les patients atteints d’insuffisance rénale.

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Section: Discussionmentioning

confidence: 57%

“…Assuming a 95% confidence interval with a 5% margin of error and a proportional variable of interest, 341 respondents were needed. According to previous experience, survey response rates for pharmacists are often low (i.e., < 20%) 16 ; therefore, the survey was sent to all CSHP members who met the inclusion criteria (n = 2499).…”

Section: Sample Sizementioning

confidence: 99%

Bisphosphonates for Osteoporosis in Patients with Renal Insufficiency: Pharmacists’ Practices and Beliefs

Sadowski

Lyder²,

Yuksel

2016

CJHP

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“…HRT with non-bioidentical hormones appears to have a worse effect on cutaneous side effects than bioidentical hormones [39]. Most dermatological adverse events associated with HRT are androgenic and probably related to exacerbated testosterone levels and its derivatives [40,41]. Androgenetic alopecia has been associated with testosterone use.…”

Section: Discussionmentioning

confidence: 99%

Dermatological Changes during Menopause and HRT: What to Expect?

Bravo,

Penedo,

Carvalho

et al. 2024

Cosmetics

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Menopause marks the end of a woman’s reproductive life. It is well-known that skin aging is accelerated during this period, as declining estrogen detrimentally impacts the skin’s extracellular matrix (ECM) which is the provider of strength and elasticity. Menopause also affects scalp hair, reducing hair diameter and leading to shorter hair growth. Objective: To evaluate the main dermatological complaints of Brazilian women during this period, comparing the compatibility of these complaints with similar studies that evaluated skin health at menopause. Methods: This study interviewed 463 postmenopausal women between 42 and 83 years old through a public electronic questionnaire in the SurveyMonkey app about their perception of the changes noticed in their hair and skin after menopause. All statistical analyses were performed in R v. 3.6.1. Results with p-values < 0.05 were considered significant. Results: Dermatological health in menopausal women, especially the quality of the skin, nails and hair may deteriorate with estrogen deficits. As life expectancy increases and hormone replacement therapy (HRT) becomes more common, a greater understanding of their dermatological effects in menopause is needed. Conclusions: Menopause strongly impacts skin quality and worsens women’s self-esteem and quality of life. There is still a lack of knowledge about HRT and specific treatments for improving skin, hair and nails.

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Bioidentical hormones for women with vasomotor symptoms

Gaudard¹,

Souza²,

Puga

et al. 2016

Cochrane Database of Systematic Reviews

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BackgroundVarious hormone therapies (HT) are available to treat menopausal vasomotor symptoms. Bioidentical hormones are chemically identical to those produced by the human body, and several types are well-tested and available on prescription. Many women have opted for bioidentical hormone therapy (BHT) on the assumption that it is safer than other forms of HT. We evaluated the evidence. ObjectivesTo determine the effectiveness and safety of bioidentical hormones compared to placebo or non-bioidentical hormones for the relief of vasomotor symptoms. Search methodsIn July 2015 we searched the Cochrane Central Register of Controlled Trials, PubMed, Embase, Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), registers of ongoing trials and the reference lists of articles retrieved. Selection criteriaRandomised controlled trials (RCTs) comparing bioidentical hormone therapy (BHT) versus placebo or non-bioidentical hormones. Data collection and analysisWe used standard methodological procedures expected by the Cochrane Collaboration. Our primary outcome was vasomotor symptoms (hot flushes and night sweats). We evaluated the overall quality of the evidence using Grading of Recommendations Assessment, Development and Evaluation criteria (GRADE). Main resultsWe included 23 RCTs (5779 participants). Most studies (20/23) included only women with moderate to severe hot flushes. All studies compared unopposed 17 beta-estradiol (beta-estradiol) versus placebo or conjugated equine estrogens (CEE). None of the studies reported night sweats as a separate outcome. BHT patch versus placebo1 Bioidentical hormones for women with vasomotor symptoms (Review)

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Beliefs about bioidentical hormone therapy: A cross-sectional survey of pharmacists

Cited by 11 publications

References 35 publications

Bisphosphonates for Osteoporosis in Patients with Renal Insufficiency: Pharmacists’ Practices and Beliefs

Bisphosphonates for Osteoporosis in Patients with Renal Insufficiency: Pharmacists’ Practices and Beliefs

Dermatological Changes during Menopause and HRT: What to Expect?

Bioidentical hormones for women with vasomotor symptoms

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