The prescribing rate of hormone replacement therapy (HRT) is 29 per cent lower in practices from the most deprived quintile compared with the most affluent, suggest the findings of a study published in the British Journal of General Practice.
The cross-sectional study used primary care prescribing data in England in 2018. The prescribing rate was defined as the number of items of HRT prescribed per 1000 registered female patients aged ≥40 years.
The association between Index of Multiple Deprivation score and HRT prescribing rate was tested, adjusting for practice proportions of obesity; smoking; hypertension; diabetes; coronary heart disease and cerebrovascular disease; and practice list size.
The overall HRT prescribing rate was 29 per cent lower in practices from the most deprived quintile compared with the most affluent (incidence rate ratio [IRR], 0.71; 95% CI, 0.68-0.73).
After adjusting for all cardiovascular disease outcomes and risk factors, the prescribing rate in the most deprived quintile was still 18 per cent lower than in the least deprived quintile (adjusted IRR, 0.82; 95% CI, 0.77-0.86).
In more deprived practices, there was a significantly higher tendency to prescribe oral HRT than transdermal preparations (P<.001).
The study demonstrates inequalities associated with HRT prescription. The authors say this may reflect a large unmet need in terms of menopause care in areas of deprivation.
