The number of women prescribed Hormone Replacement Therapy ( HRT ) fell rapidly in the Netherlands after widespread media coverage of the Million Women Study.

However a study with similar findings, which received hardly any media attention in the country when it was published the previous year, had little impact on prescribing rates.

Researchers led by a team from the University of Groningen looked at dispensing data from women aged 45-69 who had received at least one prescription for HRT.

The research covered a total study population of 233,000 women over the four-year period between 2000 and 2003 – just over 58,000 a year.

They discovered that prescribing levels fell suddenly after August 2003 when the Million Women Study was published. By the end of that year HRT was being used by 8.7 per cent of women aged 45-69 compared with 10 per cent a year earlier.

Over the same period, new users fell by 29 per cent and the number of women who continued to use HRT fell by 42 per cent.

However, the 2002 Women's Health Initiative Study failed to have the same impact in the Netherlands as the 2003 study. The researchers believe that this was partly due to the fact that the first study received little media coverage in the Netherlands – compared with other countries such as the UK and USA – while the second study was widely publicised in the Dutch medical and lay press.

Both studies reported that the risks of HRT outweighed the benefits. Cited problems included increased rates of breast cancer, coronary heart disease, stroke, dementia and venous thromboembolism. Advantages included decreased rates of hip fractures and colorectal diseases in women using long-term HRT.

" There was a modest decline in HRT prescribing following the Women's Health Initiative study, which did not receive much media coverage in the Netherlands" says Lolkje de Jong-van den Berg. " However, the publication of the Million Women's Study, which received considerable media coverage here, was followed by a sharp decline in HRT prescribing."

The authors also note that countries that did give widespread media coverage to the earlier Women's Health Initiative study, notably the USA and New Zealand, did report substantial reductions in HRT prescribing.

" We don't suggest that media coverage was the only factor affecting the reduction of HRT use in the Netherlands" saysLolkje de Jong-van den Berg. " For example the Dutch associations of gynaecologists and general practitioners were prompt to issue guidelines that HRT should only be used for short durations in women with severe complaints.

" However the media coverage, which included the front pages of six national newspapers together with women's magazines and medical journals, definitely played a role in reducing the number of women using, and being prescribed, HRT.

" This pattern does seem to be borne out by studies carried out in other countries after widespread negative media coverage of HRT research."

Source: British Journal of Clinical Pharmacology, 2005


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