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Gold, incentives and meh

Retirement timebomb goes off as GPs leave in droves

GP prescriptions of all the main types of HRT have fallen sharply since publication of landmark studies questioning the treatment's safety, a new study reports.

The drop was particularly marked for combination HRT, reflecting research findings suggesting it increases the risk of breast cancer.

But the study said HRT prescribing fell less sharply than in the US, reflecting a lack of alternative options and confusion on guidance.

The study, published as a research letter in the British Journal of General Practice (July), found overall prescribing of HRT in England and Wales fell by 19.7 per cent between 2001 and 2003. It followed yearly rises of 7.5 per cent between 1998 and 2001.

Prescribing of oestradiol with progestogen fell by 20.7 per cent and conjugated oestrogens and progestogen by 37.5 per cent between 2001 and 2003 (see graph). In the US, the overall drop was over 35 per cent.

Study leader Professor Joy Townsend, professor of public and environmental health research at the London School of Hygiene and Tropical Medicine, said: 'GPs are not sure they have appropriate guidelines.'

After publication in 2002 of the Million Women Study, GPs were told to give HRT for menopause at the lowest dose for the shortest time.

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