Practice patterns and perspectives regarding treatment for symptoms of menopause: qualitative interviews with US health care providers

Abstract

Objective: To document health care providers' views regarding treatments for symptoms associated with menopause and discussions with patients about symptoms and treatment decisions. Results informed development of a data collection form for a retrospective medical record review (reported separately).Methods: Registered US gynecologists or primary care providers from all US regions were identified from local association directories and an in-house database and were invited to participate in a qualitative interview if they consulted with three or more patients per week presenting with menopausal symptoms. Participants provided demographic data, information about patients' symptoms, and health care provider and patient views on prescription and nonprescription therapies. Key concepts/themes from interviews were identified.Results: Participating health care providers (10 gynecologists, 10 primary care providers) agreed there are effective treatment options for menopausal symptoms, particularly vasomotor symptoms and vaginal dryness and/or atrophy. Health care providers reported that treatment was generally dictated by symptoms that interfered with quality of life and/or daily activities, although patients often had symptoms for months before presentation. All health care providers said they prescribe hormone and/or nonhormone therapies for treatment of menopausal symptoms; half stated that they typically inquire about patients' nonprescription therapy use, and 45% recommend specific nonprescription therapies. The most commonly cited barriers to initiation of any therapy for menopausal symptoms were patient concerns about risks and financial considerations (ie, insurance or cost).Conclusions: US health care providers reported prescribing therapies for menopausal symptoms and noted that these therapies were perceived as generally effective; however, barriers to initiation of prescription therapy exist, and new treatment options are needed.

Treatment and resource utilization for menopausal symptoms in the United States: a retrospective review of real-world evidence from US electronic health records

“…The number of patients receiving prescription or nonprescription treatment may be higher in women with more frequent or severe VMS. Symptom severity was noted as a key factor for HCP treatment selection in the qualitative interviews conducted as part of this study 12 . Data entered may also be subject to entry errors, resulting in inaccuracies in the EHR.…”

“…Symptom severity was noted as a key factor for HCP treatment selection in the qualitative interviews conducted as part of this study. 12 Data entered may also be subject to entry errors, resulting in inaccuracies in the EHR. Although data checks were conducted to assess internal consistency of the entered data, the responses were not validated by an independent reviewer.…”

“…Findings from that noninterventional, cross-sectional, observational study will be published separately in the next issue of Menopause. 12…”

“…The results informed the development of the electronic data collection forms (DCF) that were used in the current study. Findings from that noninterventional, cross-sectional, observational study will be published separately in the next issue of Menopause 12 …”

Prospective early adulthood risk factors for vasomotor symptoms in the Coronary Artery Risk Development in Young Adults study

“…Such an analysis could inform interventions to prevent or reduce VMS, which may be undertreated 6 because of concerns regarding patient-perceived risks of existing therapies. 7 The Coronary Artery Risk Development in Young Adults (CARDIA) study is a population-based cohort study originally designed to identify risk factors for cardiovascular disease beginning when participants were aged 18 to 30 y until the most recent exam when women were aged approximately 60 y. 8 CARDIA also has collected VMS characteristics beginning at approximately 40 y of age and every 5 y thereafter, as well as information on gynecologic surgeries, menstrual cycle length, hormone use, and reproductive histories.…”