Awareness of menopause and menopause hormone therapy in India: perspectives of healthcare providers and consumers

This study was a dual-module approach that aimed to evaluate knowledge and concerns of healthcare providers (HCPs) about menopause hormone therapy (MHT) in under-resourced communities, and to understand the awareness and sources of information on menopause and MHT in these communities. The cross-sectional survey study consisted of two modules: the population module was administered offline and followed the computer-aided personal interview methodology; and the HCP module was an online, self-administered survey. Out of 32,518 women surveyed from underprivileged communities, 50% were unaware of the effects of menopause, and 62% were unaware of the available treatment; if offered by the HCP, 48% were willing to take treatment. Responses from 1261 HCPs showed that systemic MHT was prescribed by 62.4% of HCPs and vaginal estrogen therapy by 86.0%. Although 95% of HCPs were aware of the indications, risks and benefits of MHT, 57% used alternative therapies as first-line therapy and 71% used them as an adjunct to MHT. There is a lack of awareness regarding the impact of menopause on health and on the use of MHT, and educational programs may encourage women to seek help. While HCPs are knowledgeable, hesitancy in the use of systemic MHT indicates the need for professional training programs to increase confidence in prescription writing.

本研究采用双模块研究方案，旨在评估资源匮乏社区内医疗保健提供者（Healthcare Providers, HCPs）对绝经激素治疗（Menopause Hormone Therapy, MHT）的认知与顾虑，并明晰该社区人群对绝经及绝经激素治疗的认知水平与信息获取渠道。本横断面调查研究包含两个模块：人群调研模块采用线下实施方式，遵循计算机辅助个人访谈方法；HCP模块则为线上自主填写式问卷调研。本次研究共纳入32518名来自弱势社区的女性受访者，其中50%对绝经的健康影响缺乏认知，62%不清楚现有可供选择的治疗方案；若医疗保健提供者推荐该治疗，48%的受访者愿意接受治疗。1261名医疗保健提供者的反馈数据显示，62.4%的医师曾开具系统性绝经激素治疗处方，86.0%的医师曾开具阴道雌激素治疗处方。尽管95%的医疗保健提供者了解绝经激素治疗的适应证、风险与获益，但57%的医师将替代疗法作为一线治疗方案，71%的医师将其作为绝经激素治疗的辅助手段。当前该社区女性对绝经对健康的影响以及绝经激素治疗的应用仍存在认知缺口，相关健康教育项目或可推动女性主动寻求专业医疗帮助。尽管医疗保健提供者具备相关专业知识，但他们在开具系统性绝经激素治疗处方时仍存在顾虑，这表明亟需开展专业培训项目以提升医师的处方信心。