Swedish physicians' knowledge of and prescribing practices for menopausal hormone therapy: A nationwide cross-sectional survey
Rebecca Götze Eriksson, Alkistis Skalkidou, Nayara Cristina Romão Cruz, Angelica Lindén Hirschberg, Stavros I. Iliadis
Abstract
OBJECTIVES: To investigate current prescribing practices, knowledge levels and related disparities regarding menopausal hormone therapy (MHT) among physicians in Sweden. STUDY DESIGN: A 45-item web-based MHT-focused survey conducted February-September 2023. Participants were specialists/residents in obstetrics and gynecology (gynaecologists) and general practitioners (GPs) in Sweden. MAIN OUTCOME MEASURES: Experience with MHT prescription, prescription patterns and challenges and perceived knowledge of and adherence to national guidelines among gynaecologists and GPs, analyzed quantitatively, along with potential differences between the two groups. RESULTS: In total, 542 physicians answered the survey (67.9 % gynaecologists and 32.1 % GPs). Over 90 % reported meeting women with menopausal symptoms in their clinical practice and among those 94.6 % prescribed systemic MHT. GPs prescribed MHT to a significantly lesser extent than gynaecologists. GPs reported a significantly higher level of difficulty in all but one of the examined aspects of MHT prescription. GPs demonstrated significantly lower awareness of current national guidelines than gynaecologists. Regarding self-perceived assessment of MHT-related education, 47.8 % of GPs, compared with 30.6 % of gynaecologists, reported inadequate theoretical education (p < 0.001). Physicians working in metropolitan areas were more experienced in prescribing micronized progesterone and dydrogesterone. CONCLUSIONS: Differences were observed between responding gynaecologists and GPs in MHT-related practices and knowledge. While GPs reported lower awareness of guidelines and encountered more challenges in prescribing MHT, nearly one-third of gynaecologists also indicated inadequate education in MHT. This study underscores the need for improved guideline awareness and accessible education to support evidence-based menopause care for the expanding midlife female population.