Age, race, education among barriers to receiving menopausal hormone therapy
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Key takeaways:
- The most common disparities in menopausal hormone therapy prescription are age, race and education.
- Inadequate time and knowledge on the part of health care practitioners were also barriers.
PHILADELPHIA — Age, race and education are the most prevalent barriers accounting for disparities in the prescription of menopausal HT, according to presenters.
The finding came in a scoping review presented at the Annual Meeting of The Menopause Society. Researchers aimed to clarify gaps in treatment so advanced patient care among disadvantaged populations can be made more equitable.
The health care industry “can do a better job with preventative care and treatment for menopausal women,” Danette Y. Conklin, PhD, and Sally E. MacPhedran, MD, told Healio.
“Lack of education on menopause and on the benefits of menopausal hormone therapy, as well as implicit bias, are contributing to disadvantaged groups and many women not receiving adequate counseling and treatment about hormone therapy,” Conklin and MacPhedran said.
Conklin, MacPhedran and colleagues reviewed 20 studies conducted from 1973 through 2015 that involved menopause, health disparities and HT prescribing patterns. The researchers evaluated the types of disparities noted in each study.
Age was the most common disparity, reported in 65% of the studies (n = 13). Older women were prescribed more often than younger women in seven studies and less often in four studies. One study with mixed results showed women aged 50 to 59 years were prescribed HT more often than older and younger women.
Ten studies noted race as a disparity, with all 10 showing Black women were prescribed and counseled about menopausal HT less often than other groups.
The next most common disparity was in education, with six studies showing women with less education were prescribed and counseled about menopausal HT less often than those with higher education.
Six articles also mentioned practitioner characteristics that were barriers to menopausal HT, including not discussing the treatment with patients, not offering HT or lacking time and adequate knowledge about it.
“Initiatives to educate prescribing clinicians could improve the quality of care in hormone therapy counseling and treatment, reduce health care disparities and the burden of disease for peri- and postmenopausal women,” Conklin and MacPhedran told Healio.
Researchers highlighted the large variety of methods and designs across the studies they examined as a limitation of their study.