Les médecins généralistes et le traitement hormonal substitutif de la ménopause : leurs représentations sur les risques et bénéfices du traitement

Abstract : The risks of hormone replacement therapy (HRT) resulted in a decrease of prescription since the publication of the Women's Health Initiative (WHI) in 2002. Since then, many studies have rehabilitated the HRT without increasing of prescription. Our study was designed to assess the understanding of GPs (General Practitioners) who practice in Paris of the benefits and risks of HRT. It was a quantitative observational study from May to September 2017. GP’s were asked with an anonymous survey to estimate the benefits and risks of HRT on death, breast cancer, endometrial cancer, colon cancer, heart disease, stroke, venous thromboembolism, femoral fracture and Alzheimer's disease. The answers were compared to the real risks and benefits. The secondary objectives were to analyze the responses in subgroups, the representations of menopause and HRT. The analysis was performed using the Chi-2 test. 200 GP’s were selected by sampling. 67 physicians (29.8%) were included in the analysis. Only 24% of the answers were correct. 48% of respondents overestimated the risk or benefit of THM. 10.4% of the answers were false, with an error in the direction of the risk. Practitioners overestimated the risks of THM for breast cancer, VTE and endometrial cancer. Women and younger physicians significantly overestimated breast cancer. Our study suggests that the results of different THM studies are misunderstood. Inaccurate clinician’s expectations of the risks and benefits of treatment can influence the practitioners in their prescription decision. The multiplicity of studies makes access to information difficult. There is a great need for GP’s education about the risks and benefits of HRT.
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Master Thesis
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Nouhad Benchorba. Les médecins généralistes et le traitement hormonal substitutif de la ménopause : leurs représentations sur les risques et bénéfices du traitement. Médecine humaine et pathologie. 2018. ⟨dumas-01929853⟩

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