The study revealed a low rate of MHT prescription among primary care doctors, with many relying on referrals to hospitals for managing menopausal symptoms, underscoring the need for strategies that include fulfilling professional training gaps, improving MHT availability, and improving information dissemination for patients.
Key Findings
Results
Although two-thirds of primary care doctors reported offering MHT, the actual prescription rate was very low with most opting to refer patients to hospitals.
66.9% of participants reported offering MHT to their patients
The actual prescription rate was only 0.9%
66% of PCDs would refer patients to hospitals rather than prescribing directly
87.1% of PCDs (487/559) reported that MHT was not available in their clinic
Methods
The response rate was 42.9% from a cross-sectional survey of primary care doctors in the Federal Territory of Kuala Lumpur, Federal Territory of Putrajaya, and state of Selangor.
559 out of 1301 invited PCDs responded (response rate 42.9%)
77.8% of PCDs were female
89.1% were medical officers
All PCDs provided services in government primary care clinics from the three regions
Results
The majority of primary care doctors had not received any training on menopause management in the past 12 months.
83% of PCDs had not received any related training in the past 12 months
Receiving training on menopause management was a positive predictor of offering MHT (AOR: 2.7, CI: 1.30–5.56, p = 0.008)
Results
Female sex was a significant positive predictor of offering MHT among primary care doctors.
Female PCDs had an adjusted odds ratio of 2.5 (CI: 1.51–4.13, p < 0.001) for offering MHT compared to male PCDs
77.8% of the study participants were female
Results
Perceiving MHT as the preferred treatment for menopausal symptoms and likelihood to recommend MHT to family and friends were positive predictors of offering MHT.
Perceiving MHT as preference treatment for menopause symptom: AOR 3.6 (CI: 2.13–6.19, p < 0.001)
Having likelihood to recommend MHT to family and friends: AOR 3.0 (CI: 1.87–4.83, p < 0.001)
These were among the strongest positive predictors identified in multivariate logistic regression
Results
Lack of prescribing experience and lack of patient information regarding MHT were significant negative predictors of offering MHT.
No experience in prescribing MHT: AOR 0.4 (CI: 0.15–0.87, p = 0.024)
Lack of information regarding MHT for the patient: AOR 0.4 (CI: 0.20–0.67, p < 0.001)
Both factors approximately halved the odds of a PCD offering MHT
Background
A local study cited in the background found that usage of MHT among menopausal women was low, with not being recommended by doctors as one of the main reasons.
MHT usage among menopausal women was found to be 8.1% in a prior local study
One of the main reasons for low usage was that MHT was not recommended by doctors
Guidelines recommend MHT as the most effective treatment for menopausal symptoms
Low T, Cheong A, Devaraj N, Ismail R. (2024). Prevalence of offering menopause hormone therapy among primary care doctors and its associated factors: A cross-sectional study.. PloS one. https://doi.org/10.1371/journal.pone.0310994