Recorded presentation

Debra A. Heller, PhD¹, Carol H. Gold, PhD², Frank M. Ahern, PhD², Kristine E. Pringle, MS¹, Theresa V. Brown, MPA³, and Margaret R. Glessner, PharmD¹. (1) The PACE Program, First Health Services Corporation, 4000 Crums Mill Rd, Suite 301, Harrisburg, PA 17112, 717-651-3629, daheller@fhsc.com, (2) Department of Biobehavioral Health, The Pennsylvania State University, 315 East Health and Human Development, University Park, PA 16802, (3) The PACE Program, Pennsylvania Department of Aging, 555 Walnut St., 5th Floor, Harrisburg, PA 17101

Many women have discontinued hormone replacement therapy (HRT) in view of recent findings. The goal of this study was to determine if HRT discontinuation is associated with changes in health-related quality of life (HRQOL) in elderly women. We studied women enrolled in Pennsylvania’s Pharmaceutical Assistance Contract for the Elderly (PACE) program, linking prescription claims with data from a longitudinal mail survey. HRQOL measures included the number of days out of the last 30 that physical health was not good and analogous measures for mental health, pain, and interference with activities, as well as a composite “healthy days” measure developed by CDC. Longitudinal analyses focused on 2,124 women who completed surveys in both 2002 and 2003, and who used HRT at baseline (mean age=75, range=65-96).

Between 2002 and 2003, 43% of HRT users discontinued therapy. Propensity scores were used to match HRT continuers and discontinuers according to type of HRT, other drug use, demographics, and HRQOL at baseline. Analysis of covariance to compare HRQOL change in continuers and discontinuers revealed complex interactions with age. Discontinuers aged 65-74 reported greater increases in pain (p=0.03) and interference with activities (p=0.01). No significant effects of discontinuation on HRQOL were found in women aged 75-84. Discontinuers aged 85+ experienced apparent HRQOL improvements following cessation, with fewer “not good” physical days (p=0.03) and more “healthy days” (p=0.008).

These results suggest that there are substantial age differences in response to HRT discontinuation. Additional associations, including data on HRT duration and non-HRT drug use, will also be presented.

Learning Objectives:

• 3. Discuss health-related quality of life issues relevant to HRT use and discontinuation in older women.
  7. Construct an analytic plan to evaluate associations between HRT discontinuation and health-related quality of life.
  11. Understand how age differences may produce variability in elderly women’s responses to HRT discontinuation.

Keywords: Women, Quality of Life

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Recorded presentation