sábado, 24 de marzo de 2012

Women's Health Highlights: Recent Findings (continued) [4]

Women's Health Highlights: Recent Findings (continued)

Women's Health Highlights: Recent Findings

Women and Medications

  • Women's use of complementary and alternative medicine varies according to sexual orientation. According to this study, lesbians are more likely than heterosexual women to use complementary and alternative medicine (CAM). Of the 479 selfidentified lesbians who participated in a 2003-2006 survey, 57 percent reported having used CAM compared with 41 percent of heterosexual women. Other predictors of CAM use included white race, having more years of education, experiencing discrimination in a health care setting, living in a large city, being very spiritual, and having a history of a mental health disorder. Smith, Matthews, Markovic, et al., J Altern Complement Med 16(11):1161-1170, 2010 (AHRQ grant HS17587).
  • Women want information about the risk medications pose to an unborn child. Researchers conducted focus groups with 36 women aged 18 to 45 to ascertain their views on counseling about risks for medication-induced birth defects. Many of the women taking medications for chronic conditions said their providers skirted the issue when prescribing a new medication by advising them to use a backup method of birth control, and in some cases, the risk for birth defects was not discussed at all. All of the women said they wanted to receive such information from their health care providers, even if they did not plan to become pregnant. Santucci, Gold, Akers, et al., Birth Defects Res 88(1):64-69, 2010 (AHRQ grant HS17093).
  • Drug treatment for overactive bladder symptoms produces modest results. About 11 million U.S. women have overactive bladder syndrome and have symptoms such as strong urges to urinate, difficulty waiting to go, and involuntary loss of urine when they have an urge to urinate. A review of available evidence found that drug therapy and behavioral interventions produce modest results in reducing overactive bladder symptoms in women, while complementary and alternative therapies appeared to be ineffective. Surgical and procedural interventions were effective in some women, but more information is needed on their safety and effectiveness. Treatment of Overactive Bladder in Women, Evidence Report/Technology Assessment No. 187 (AHRQ Publication No. 09-E017)* (AHRQ contract 290-2007-10065-I).
  • Women are prescribed more drugs than men during their reproductive years. According to this study, women in their reproductive years received more prescriptions than same-age men in 48 of 53 drug classes. These included drugs commonly used to treat urinary tract and vaginal infections, migraine headaches, mental health conditions, pain, and gastrointestinal ailments. As they aged, the prescribing patterns changed; men received more drugs than women for angina, heart failure, high blood pressure, elevated cholesterol, and risk of blood clots, even though older women suffer from these conditions at the same rate as men. Anthony, Lee, Bertram, et al., J Women's Health 17(5):735-743, 2008 (AHRQ grant HS17001).
  • Pregnant women continue to receive a class of high blood pressure medications dangerous to the fetus. Use of angiotensin-converting enzyme (ACE) inhibitors during the second and third trimesters of pregnancy to treat high blood pressure is dangerous to the fetus, yet the number of pregnant women prescribed these medications increased steadily between 1986 and 2003, according to this study. This increase was despite an FDA black box warning against such use issued in 1992. The researchers examined data on 262,179 Medicaid-enrolled pregnant women and found that the use of ACE inhibitors increased 4.5-fold (from 11.2 to 58.9 per 10,000 pregnancies) during the study period. Bowen, Ray, Arbogast, et al., Am J Obstet Gynecol 198:291,e1-291,e5, 2008 (AHRQ grant HS10384).
  • Use of oral diabetes agents or insulin to treat gestational diabetes appears beneficial, and the likelihood of harm is low. This review of the evidence focused on the risks and benefits associated with use of an oral diabetes agent compared with all types of insulin for gestational diabetes. Other areas reviewed include any risk factors that might be associated with the development of type 2 diabetes after gestational diabetes; the reliability of diagnostic tests for type 2 diabetes in women with gestational diabetes; and whether there is evidence that elective labor induction, cesarean delivery, or timing of induction is associated with risks and benefits for mother and neonate. Therapeutic Management, Delivery, and Postpartum Risk Assessment and Screening in Gestational Diabetes, Evidence Report/Technology Assessment No. 162 (AHRQ Publication No. 08-E004)* (AHRQ contract 290-02-0018).

Data Sources for Gender Research

Medical Expenditure Panel Survey
In 1996, AHRQ launched the Medical Expenditure Panel Survey (MEPS), a nationally representative survey to collect detailed information on health status, health care use and expenses, and health insurance coverage for individuals and families in the United States, including nursing home residents. MEPS is helping the Agency to address many questions important to women, including how health insurance coverage, access to care, use of preventive care, the growth of managed care, changes in private health insurance, and other changes in the health care system are affecting the kinds, amounts, and costs of health care services used by women. For more information related to MEPS, go to http://meps.ahrq.gov.
Healthcare Cost and Utilization Project
The Healthcare Cost and Utilization Project (HCUP) is a family of health care databases and related software tools and products sponsored by AHRQ and developed through a Federal-State-industry partnership. HCUP includes the largest collection of longitudinal hospital care data in the United States, with all-payer, encounter-level information beginning in 1988. These databases enable research on a broad range of health policy issues that are pertinent to women, including the cost and quality of health services, access to care, and patient outcomes at the national, State, and local levels. HCUP comprises the following databases:
  • Nationwide Inpatient Sample (NIS), with inpatient data from a national sample of over 1,000 hospitals.
  • Kids' Inpatient Database (KID), a nationwide sample of pediatric inpatient discharges.
  • State Inpatient Databases (SID), which contain the universe of inpatient discharge abstracts from participating States.
  • State Ambulatory Surgery Databases (SASD), which contain outpatient data on surgical encounters.
  • State Emergency Department Databases (SEDD), which contain data from hospital-affiliated emergency departments.
For more information about HCUP, go to http://www.hcup-us.ahrq.gov

More Information

For more information on AHRQ initiatives related to women's health, please contact:
Beth Collins Sharp, Ph.D., R.N.
Senior Advisor, Women's Health and Gender Research
Agency for Healthcare Research and Quality
540 Gaither Road
Rockville, MD 20850
Telephone: 301-427-1503
E-mail: Beth.CollinsSharp@ahrq.hhs.gov
For more information about AHRQ and its research portfolio and funding opportunities, visit the Agency's Web site at http://www.ahrq.gov.

Items marked with an asterisk (*) are available free from the AHRQ Clearinghouse. To order, contact the clearinghouse at 800-358-9295 or request electronically by sending an E-mail to ahrqpubs@ahrq.gov. Please use the AHRQ publication number when ordering.
Please use the AHRQ publication number when ordering.

Current as of March 2012
AHRQ Publication No. 12-P002
(Replaces AHRQ Publication No. 10-P005)

Internet Citation:
AHRQ Women's Health Highlights: Recent Findings. Program Brief. AHRQ Publication No. 12-P002, March 2012. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/research/womenh1.htm

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