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F206 The impact of hormone replacement therapy on quality of life and willingness to pay
F206 THE IMPACT OF HO~ONE ~PLACEMENT ON QUALITY OF LIFE AND WILLINGNESS
F207 THERAPY TO PAY
HO~ONE SPACEMEN THERAPY AND PREVIOUS USE OF ORAL CONTRACEPTIVES AMONG SWEDISH WOMEN
R T Strand, Dpt of Gynaecology and P Henrikssun, Dpt of Medicine, both at Sbdertal.jeHospital 152 86 Sodertalje, Sweden; N Zethraeus and M Juhan~essaa, Stockholm School of Economics, Center of Health Economics, PO Box 6501, 113 83 Stockholm, Sweden
J 0 Brvnhildsem, C L Dabrosin, J Frisk, R Lindgren, E E Nedstrand, Y A Wyon, ML Hamnar, Dept of Obstetrics and Gynaecology, Faculty of Health Sciences, Unive~ity Hospital, L~nk~ping, S-581 85 Sweden.
The purpose of this study was to measurethe gain in quality of life (QoL) due to hormone replacementtherapy (HRT) for women with mild and severe menopausal symptoms. Rata were collected from 104 women visiting the gynecological dpt of Siidertaije Hospital. The women had beenusing HRT for at least one month and were agedbetween 45 and 65 years. The quality-adjusted life-year (QALY) weight was measured with rating scaie (RS) and the time trade off method. (TTO) Wiilingness to pay (WTP) was assessed on an individual basis. For women with mild symptoms the increase in QALY weight due to HRT was 0.26 (PcO.05) according to the RS and 0.18 (P
The objective was to assess the current and previous use of hormone replacement therapy (HRT) and alternative remedies in a postmenopausal population and to relate HRT use to previous use of oral contraceptives. All 1323 women living in Linkoping being 55 or 56 year old during 1995 were sent a questionnaire asking for data with relation to health and climacteric symptoms as well as to previous and current use of HRT, oral contraceptives and alternative remedies, Current use of HRT was more common among women who previously used oral contraceptives (41.3 %) than among women who had never used oral contraceptives (23.1%). HRT users were also more often physically active, had undergone hysterectomy and had lighter occupation than non users. Of all women 35% were current users of HRT, half of them since at least two years, whereas only 5% had tried HRT and abandoned therapy. Alternative remedies were used by 5% of the women as therapy for climacteric complaints, and about four times as many women had tried such therapy but abandoned it. The only characteristic about use of alternative medicines was that they were used less oRen by women who had been hysterectomized. No woman treated for breast cancer used HRT and only few of them used alternative remedies. In conclusion the prevalence of HRT use, as well as compliance, was high. Previous use of oral contraceptives probably affected the attitude towards using HRT.
F208
F208 (cant)
EXPERIENCES OF MENOPAUSE AMONGST GREEKSPEAKING WOMEN IN AN AUSTRALIAN CITY B, Ka~a~e~js, C. Bfaek, #? Cable, J. Daly* and P.A. Ko~esara~~ Baker Medical Research Institute, P.O. Box 348 Prahran, Victoria 3181, Australia & *Department of Sociology, La Trobe University, Bundoora, Victoria, Australia. Several studies have shown that cultural and economic factors influence both experiences of menopause and the use of health services by women and that a failure to appreciate this may lead to inappropriate medical care and ineffective preventive health strategies. Although these facts are well established, the precise nature and impact of cultural variables on the ways in which Greek women view midlife and menopause are uncertain. We are therefore undertaking a qualitative study of women attending a recentlyopened Greek Women’s Clinic in Melbourne. The study is also being used to assist in the development of the clinic by providing information about the special needs of this group of patients and allowing the testing of strategies designed to respond to them. Forty women aged 45 to 60 are to be interviewed on five separate occasions over two years. Thematic analysis performed halfway through shows that the experiences of menopause cannot be separated from other details of the women’s lives. Family relationships, the economy, health challenges, fears about cancer, concerns about death and ageing and, most importantly, religious beliefs all have profound and characteristic effects. Furthermore, culturally-conditioned concepts of the body and illness and conflicts across generations can decisively intluence both the expression of symptoms and the effectiveness of therapeutic interventions. Continued 108
Many women recount past unfavourable or unsatisfacto~ encounters with medicine. In their view, these have often reflected a lack of interest by doctors in their life stories; on occasions, there has evidently also been a failure of communication about clinical assessments and recommended treatments, leading either to inappropriate care or to disillusionment with medicine in general. The insights derived from our study have enabled us to devise clinical practices that we hope will be both more acceptable to the women and more effective. They also emphasise the need for medical services that are sensitive to the requirements of specific cultural groups. The process we have established for the evolution of our clinic may serve as a model for the development of other clinics seeking to direct themselves to the needs of particular social groups or communities.
F207 THERAPY TO PAY
HO~ONE SPACEMEN THERAPY AND PREVIOUS USE OF ORAL CONTRACEPTIVES AMONG SWEDISH WOMEN
R T Strand, Dpt of Gynaecology and P Henrikssun, Dpt of Medicine, both at Sbdertal.jeHospital 152 86 Sodertalje, Sweden; N Zethraeus and M Juhan~essaa, Stockholm School of Economics, Center of Health Economics, PO Box 6501, 113 83 Stockholm, Sweden
J 0 Brvnhildsem, C L Dabrosin, J Frisk, R Lindgren, E E Nedstrand, Y A Wyon, ML Hamnar, Dept of Obstetrics and Gynaecology, Faculty of Health Sciences, Unive~ity Hospital, L~nk~ping, S-581 85 Sweden.
The purpose of this study was to measurethe gain in quality of life (QoL) due to hormone replacementtherapy (HRT) for women with mild and severe menopausal symptoms. Rata were collected from 104 women visiting the gynecological dpt of Siidertaije Hospital. The women had beenusing HRT for at least one month and were agedbetween 45 and 65 years. The quality-adjusted life-year (QALY) weight was measured with rating scaie (RS) and the time trade off method. (TTO) Wiilingness to pay (WTP) was assessed on an individual basis. For women with mild symptoms the increase in QALY weight due to HRT was 0.26 (PcO.05) according to the RS and 0.18 (P
The objective was to assess the current and previous use of hormone replacement therapy (HRT) and alternative remedies in a postmenopausal population and to relate HRT use to previous use of oral contraceptives. All 1323 women living in Linkoping being 55 or 56 year old during 1995 were sent a questionnaire asking for data with relation to health and climacteric symptoms as well as to previous and current use of HRT, oral contraceptives and alternative remedies, Current use of HRT was more common among women who previously used oral contraceptives (41.3 %) than among women who had never used oral contraceptives (23.1%). HRT users were also more often physically active, had undergone hysterectomy and had lighter occupation than non users. Of all women 35% were current users of HRT, half of them since at least two years, whereas only 5% had tried HRT and abandoned therapy. Alternative remedies were used by 5% of the women as therapy for climacteric complaints, and about four times as many women had tried such therapy but abandoned it. The only characteristic about use of alternative medicines was that they were used less oRen by women who had been hysterectomized. No woman treated for breast cancer used HRT and only few of them used alternative remedies. In conclusion the prevalence of HRT use, as well as compliance, was high. Previous use of oral contraceptives probably affected the attitude towards using HRT.
F208
F208 (cant)
EXPERIENCES OF MENOPAUSE AMONGST GREEKSPEAKING WOMEN IN AN AUSTRALIAN CITY B, Ka~a~e~js, C. Bfaek, #? Cable, J. Daly* and P.A. Ko~esara~~ Baker Medical Research Institute, P.O. Box 348 Prahran, Victoria 3181, Australia & *Department of Sociology, La Trobe University, Bundoora, Victoria, Australia. Several studies have shown that cultural and economic factors influence both experiences of menopause and the use of health services by women and that a failure to appreciate this may lead to inappropriate medical care and ineffective preventive health strategies. Although these facts are well established, the precise nature and impact of cultural variables on the ways in which Greek women view midlife and menopause are uncertain. We are therefore undertaking a qualitative study of women attending a recentlyopened Greek Women’s Clinic in Melbourne. The study is also being used to assist in the development of the clinic by providing information about the special needs of this group of patients and allowing the testing of strategies designed to respond to them. Forty women aged 45 to 60 are to be interviewed on five separate occasions over two years. Thematic analysis performed halfway through shows that the experiences of menopause cannot be separated from other details of the women’s lives. Family relationships, the economy, health challenges, fears about cancer, concerns about death and ageing and, most importantly, religious beliefs all have profound and characteristic effects. Furthermore, culturally-conditioned concepts of the body and illness and conflicts across generations can decisively intluence both the expression of symptoms and the effectiveness of therapeutic interventions. Continued 108
Many women recount past unfavourable or unsatisfacto~ encounters with medicine. In their view, these have often reflected a lack of interest by doctors in their life stories; on occasions, there has evidently also been a failure of communication about clinical assessments and recommended treatments, leading either to inappropriate care or to disillusionment with medicine in general. The insights derived from our study have enabled us to devise clinical practices that we hope will be both more acceptable to the women and more effective. They also emphasise the need for medical services that are sensitive to the requirements of specific cultural groups. The process we have established for the evolution of our clinic may serve as a model for the development of other clinics seeking to direct themselves to the needs of particular social groups or communities.