Does hormone replacement therapy affect the use of prescription medicines in postmenopausal women: experience from the Estonian Postmenopausal Hormone Therapy Trial [ISRCTN35338757]

Abstract

Objective To determine how postmenopausal hormone therapy (HRT) is related to the use of other prescription medication.Design Follow up of a randomised controlled trial with a blind subtrial of hormone therapy versus placebo and a nonblind subtrial of open label hormone therapy versus nontreatment. Main outcome measures The use of 21 classes of prescription medication was compared in the hormone therapy arms and placebo or nontreatment trial arms. The influence of women's socio-economic characteristics on the intensity of concomitant medication use was also examined.Results The proportion of women using any prescription medication besides hormone therapy did not differ between the arms. However, the type of prescribed drugs varied between the arms. After combining data from both hormone therapy arms, for women using HRT the combined hazard ratio was 1.26 (95% CI: 1.05-1.53) for the use of calcium channel blockers, 1.48 (95% CI: 1.10-1.99) for local vaginal treatment, 0.70 (95% CI: 0.50-0.99) for hypnotics and sedatives and 0.77 (95% CI: 0.60-0.99) for selective serotonin reuptake inhibitors (SSRIs). Women who were older, who had a higher body mass index, who were unemployed and who lived outside the capital used more prescription drugs in comparison with others.Conclusions Hormone therapy did not increase the overall use of prescription medication other than hormone therapy, but the types of drugs used in hormone therapy and nontherapy arms varied, with increased use of calcium channel blockers for hypertension and local vaginal treatments for vaginal candidiasis and decreased use of hypnotics, sedatives and SSRIs in the HRT arms.

Experiences of a long-term randomized controlled prevention trial in a maiden environment: Estonian Postmenopausal Hormone Therapy trial

“…The Estonian Health Insurance Fund Database, the Estonian Cancer Registry and the Estonian Mortality Database made it possible to collect information about women's health and health services use. The Estonian Health Insurance Fund Database is unique and includes information on all health care visits, diagnosis and prescriptions [ 28 ].…”

Variability of bothersome menopausal symptoms over time – a longitudinal analysis using the Estonian postmenopausal hormone therapy trial (EPHT)

“…Throughout the trial, about 90% of women in the non-treatment group and 95% in the placebo group did not start hormone therapy [24]. The power calculations were made for the main study [21-23], but not for this cohort study based on the trial data.…”