Evidence map›Paper›PMID 41035437›Full record

ArticleBMJ medicine2025

Inequalities in hormone replacement therapy prescribing in UK primary care: population based cohort study.

Jennifer A Hirst, Wema Meranda Mtika, Carol Coupland, Sharon Dixon, Julia Hippisley-Cox, Sarah Hillman

Abstract read
In one paragraph

Article in BMJ medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Factors Associated With Menopause Symptoms: A Systematic Review and Meta-Analysis.BJOG : an international journal of obstetrics and gynaecology · 2026
    Pooled it
  2. Hormone therapy (HT) in women with premature ovarian insufficiency or early menopause: Time to think of a new paradigm for healthy aging. A joint FIGO and IMS position paper.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2026
    Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Jennifer A HirstNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.ORCID https://orcid.org/0000-0002-8416-2159
Wema Meranda MtikaNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.ORCID https://orcid.org/0009-0007-1242-4889
Carol CouplandWolfson Institute of Population Health, Queen Mary University of London, London, UK.
Sharon DixonNuffield Department of Primary Health Care Sciences, University of Oxford, Oxford, UK.
Julia Hippisley-CoxWolfson Institute of Population Health, Queen Mary University of London, London, UK.
Sarah HillmanSchool of Health Sciences, University of Birmingham, Birmingham, UK.ORCID https://orcid.org/0000-0002-3560-2074

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objective: To quantify prescribing of hormone replacement therapy (HRT) in women aged 40-60 years by type of HRT and length of use, and to determine sociodemographic factors associated with receiving a HRT prescription. Design: Population based cohort study. Setting: QResearch database of primary care practices in England, 1 January 2013 to 13 July 2023, and patient electronic health records for prescribing information . Participants: 1 978 348 women aged 40-60 years at any time over a 10 year period. Main outcome measures: Overall uptake of two or more prescriptions of the same type of HRT in women of menopausal age, length of use, and association between ethnic group, deprivation, and geographical region and receiving a HRT prescription before and during the eight years since implementation of National Institute for Health and Care Excellence (NICE) guidance on the menopause in 2015 in the UK. Results: The cohort comprised 1 978 348 women with a mean age of 49.4 years, and 76.2% were white women. Overall, 379 911 (19.2%) women received two or more HRT prescriptions. Combination HRT formulations in one prescription were the most frequently prescribed (62.4% of those prescribed HRT), with 43.3% receiving oral and 26.3% transdermal formulations. Mean age at first prescription was 49.8 years. Rates for two or more prescriptions of HRT were higher in white women (22.6%) than in other ethnic groups, ranging from 8.9% in Caribbean women to 3.9% in black African women. Prescription rates decreased with increasing social deprivation, from 24.2% in the most affluent to 10.9% in the most deprived groups. London had lower prescription rates (11.7%) than other regions (all >19%). Multivariable Cox regression showed that non-white ethnic groups had significantly lower HRT prescription rates (hazard ratios 0.85-0.92, P<0.001), and each increase in social deprivation group was associated with lower HRT prescription rates (hazard ratio for the most deprived group 0.92, 95% confidence interval 0.92 to 0.93, P<0.001). Conclusions: This study identified differences in HRT prescribing in England based on ethnic group, socioeconomic status, and geographical location. White women and those in more affluent neighbourhoods were more likely to receive HRT than non-white women and those in more deprived areas. These findings suggest potential inequities that require further exploration.

Indexed as

EpidemiologyHormone replacement therapyPrimary health care

Identifiers

PMID41035437
PMCPMC12481343

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.