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The medical management of menopause: A four-country comparison care in urban areas

Show simple item record Sievert L.L. Saliba M. Reher D. Sahel A. Hoyer D. Deeb M. Obermeyer C.M.
dc.contributor.editor 2008 2017-10-18T13:33:49Z 2017-10-18T13:33:49Z 2008
dc.identifier 10.1016/j.maturitas.2007.11.001
dc.identifier.issn 03785122
dc.description.abstract Objective: To compare the medical management of menopause across urban areas in four countries which differ by level of income and degree of medicalization. Methods: Surveys of health providers who advise women on the menopausal transition were carried out in Beirut, Lebanon (n = 100), Madrid, Spain (n = 60), Worcester, MA, U.S. (n = 59), and Rabat, Morocco (n = 50) between 2002 and 2004. Physician characteristics, hormone therapy (HT) prescribing practices, and concerns about the management of menopause were compared across countries using χ2 and logistic regression analyses. Results: Across sites, physicians were generally well informed about HT and thought that symptom alleviation and disease prevention were equally important. They had concerns about risks associated with HT, particularly breast cancer, and in 3 sites where the survey was conducted after the WHI (Beirut, Rabat, and Madrid) physicians changed their practices to prescribe HT less frequently, for shorter durations, or shifted to other medications. There were significant differences across sites in the recommended duration of HT, time spent talking with patients, perceived benefits of HT, tests recommended before prescribing HT, and concern about the risks associated with HT. Physicians in Madrid and Massachusetts were more likely to report that decisions about the management of menopause were difficult, but in all sites the main reason for difficulties was concerns about risks. The results also suggest discrepancies between physicians' perceptions and women's reports about the reasons why women consult at menopause. Conclusions: Prescription patterns and perceived benefits of HT appear to reflect local medical culture rather than simply physician characteristics. The impact of the WHI study was seen in prescribing patterns and concerns about HT. Physicians in all four countries were generally well informed. Financial support: NIH 5 900 000196. © 2007 Elsevier Ireland Ltd. All rights reserved.
dc.format.extent Pages: (7-21)
dc.language English
dc.publisher CLARE
dc.relation.ispartof Publication Name: Maturitas; Publication Year: 2008; Volume: 59; no. 1; Pages: (7-21);
dc.source Scopus
dc.title The medical management of menopause: A four-country comparison care in urban areas
dc.type Article
dc.contributor.affiliation Sievert, L.L., Department of Anthropology, Machmer Hall, 240 Hicks Way, UMass Amherst, Amherst, MA 01003-9278, United States
dc.contributor.affiliation Saliba, M., Epidemiology and Population Health, American University of Beirut, Lebanon
dc.contributor.affiliation Reher, D., Social and Political Sciences, Universidad Complutense, Madrid, Spain
dc.contributor.affiliation Sahel, A., Institut National d'Administration Sanitaire, Rabat, Morocco
dc.contributor.affiliation Hoyer, D., Fallon Clinic, Inc., Worcester, MA, United States
dc.contributor.affiliation Deeb, M., Epidemiology and Population Health, American University of Beirut, Lebanon
dc.contributor.affiliation Obermeyer, C.M., Harvard University, Boston, United States
dc.contributor.authorAddress Sievert, L.L.; Department of Anthropology, Machmer Hall, 240 Hicks Way, UMass Amherst, Amherst, MA 01003-9278, United States; email:
dc.contributor.authorCorporate University: American University of Beirut; Faculty: Faculty of Health Sciences; Department: Epidemiology and Population Health;
dc.contributor.authorDepartment Epidemiology and Population Health
dc.contributor.authorFaculty Faculty of Health Sciences
dc.contributor.authorInitials Sievert, LL
dc.contributor.authorInitials Saliba, M
dc.contributor.authorInitials Reher, D
dc.contributor.authorInitials Sahel, A
dc.contributor.authorInitials Hoyer, D
dc.contributor.authorInitials Deeb, M
dc.contributor.authorInitials Obermeyer, CM
dc.contributor.authorReprintAddress Sievert, LL (reprint author), UMass Amherst, Dept Anthropol, Machmer Hall,240 Hicks Way, Amherst, MA 01003 USA.
dc.contributor.authorUniversity American University of Beirut
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dc.description.citedCount 12
dc.description.citedTotWOSCount 11
dc.description.citedWOSCount 11
dc.format.extentCount 15
dc.identifier.coden MATUD
dc.identifier.pubmedID 18178044
dc.identifier.scopusID 38749118224
dc.relation.ispartOfISOAbbr Maturitas
dc.relation.ispartOfIssue 1
dc.relation.ispartofPubTitle Maturitas
dc.relation.ispartofPubTitleAbbr Maturitas
dc.relation.ispartOfVolume 59
dc.source.ID WOS:000253804600003
dc.type.publication Journal
dc.subject.otherAuthKeyword Hormone therapy
dc.subject.otherAuthKeyword Lebanon
dc.subject.otherAuthKeyword Medicalization
dc.subject.otherAuthKeyword Menopause
dc.subject.otherAuthKeyword Morocco
dc.subject.otherAuthKeyword Physician prescribing practices
dc.subject.otherAuthKeyword Spain
dc.subject.otherAuthKeyword United States
dc.subject.otherIndex adult
dc.subject.otherIndex article
dc.subject.otherIndex drug safety
dc.subject.otherIndex female
dc.subject.otherIndex hormone substitution
dc.subject.otherIndex human
dc.subject.otherIndex income
dc.subject.otherIndex Lebanon
dc.subject.otherIndex logistic regression analysis
dc.subject.otherIndex male
dc.subject.otherIndex medical practice
dc.subject.otherIndex menopause
dc.subject.otherIndex physician attitude
dc.subject.otherIndex prescription
dc.subject.otherIndex Spain
dc.subject.otherIndex urban population
dc.subject.otherIndex Biopsy
dc.subject.otherIndex Bone Density
dc.subject.otherIndex Decision Making
dc.subject.otherIndex Endometrium
dc.subject.otherIndex Female
dc.subject.otherIndex Health Care Surveys
dc.subject.otherIndex Hormone Replacement Therapy
dc.subject.otherIndex Humans
dc.subject.otherIndex Lebanon
dc.subject.otherIndex Mammography
dc.subject.otherIndex Massachusetts
dc.subject.otherIndex Menopause
dc.subject.otherIndex Middle Aged
dc.subject.otherIndex Morocco
dc.subject.otherIndex Physician's Practice Patterns
dc.subject.otherIndex Physician-Patient Relations
dc.subject.otherIndex Spain
dc.subject.otherIndex Specialties, Medical
dc.subject.otherIndex Urban Health Services
dc.subject.otherIndex Urban Population
dc.subject.otherKeywordPlus HORMONE REPLACEMENT THERAPY
dc.subject.otherKeywordPlus ESTROGEN PLUS PROGESTIN
dc.subject.otherKeywordPlus RANDOMIZED CONTROLLED-TRIAL
dc.subject.otherKeywordPlus POSTMENOPAUSAL WOMEN
dc.subject.otherKeywordPlus PRESCRIBING PRACTICES
dc.subject.otherKeywordPlus OBSTETRICIAN-GYNECOLOGISTS
dc.subject.otherKeywordPlus PRACTICE PATTERNS
dc.subject.otherKeywordPlus HEALTH
dc.subject.otherKeywordPlus ATTITUDES
dc.subject.otherKeywordPlus PRESCRIPTION
dc.subject.otherWOS Geriatrics and Gerontology
dc.subject.otherWOS Obstetrics and Gynecology

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