O artigo de pequisadores da UNICAMP publicado em Maturitas com resumo abaixo (texto pode ser solicitado ao autor em flj@uol.com.br) , mostra que não há espaço para tanta manipulação nas condutas médicas. Apesar da enorme campanha para desacreditar os resultados do Women´s Health Initiative por médicos com laços evidentes com a indústria farmacêutica, parte considerável dos ginecologistas paulistas se renderam aos fatos revelados nesse mega ensaio clínico. O Women´s Health Initiative foi o mais caro ensaio clínico americano e, entre outros resultados mostrou que o princípio proposto de prevenção da doença cardiovascular com o uso de estrógenos ou estrógenos-progestágenos, não somente não previne, como aumenta o risco.
Mesmo antes dos resultados, sempre alertei para o equívoco de se utilizar um medicamento para sintomas como forma de prevenção da doença cardiovascular. Resta somente, agora seu uso como sintomático por curto tempo, o que já é uma boa indicação.
Maturitas. 2007 Feb 20;56(2):129-41. Lazar F Jr, Costa-Paiva L, Morais SS, Pedro AO, Pinto-Neto AM. Department of Obstetrics and Gynecology, School of Medical Sciences, State University of Campinas (Unicamp), flj@uol.com.br
OBJECTIVE: The objective of this study was to evaluate gynecologists' knowledge of the WHI study, and its repercussions on their attitudes and practice 3 years after publication. DESIGN: A self-administered, anonymous questionnaire containing 19 questions was sent to 6000 gynecologists, members of the Sao Paulo Society of Obstetrics and Gynecology. RESULTS: The response rate was 24.2% (1453 completed questionnaires) with a sample error of 2.23% and confidence level of 95%. Although 95.9% of the respondents were aware of the WHI study, only 24.4% knew of all the other studies mentioned (HERS I, HERS II and Million Women Study). Although 84.6% stated that the results of the WHI study could not be extrapolated to other forms of HT, 23.1% and 25.2%, respectively, stopped prescribing CEE or MPA, 63.7% decreased the dose, 55.2% opted for drugs such as bisphosphonates, tibolone and SERMS, and 46.3% began to prescribe tranquilizers, isoflavone and other natural medications. Moreover, 59.2% agreed that HT should be used for only 4-5 years. Prescriptions decreased significantly for all indications (p<0.0001).> A high percentage of gynecologists in this study knew of the WHI study and followed its recommendations concerning cardiovascular prevention; consequently they changed their management of the treatment of postmenopausal women by restricting indications for HT and decreasing its duration of use and dose.
OBJECTIVE: The objective of this study was to evaluate gynecologists' knowledge of the WHI study, and its repercussions on their attitudes and practice 3 years after publication. DESIGN: A self-administered, anonymous questionnaire containing 19 questions was sent to 6000 gynecologists, members of the Sao Paulo Society of Obstetrics and Gynecology. RESULTS: The response rate was 24.2% (1453 completed questionnaires) with a sample error of 2.23% and confidence level of 95%. Although 95.9% of the respondents were aware of the WHI study, only 24.4% knew of all the other studies mentioned (HERS I, HERS II and Million Women Study). Although 84.6% stated that the results of the WHI study could not be extrapolated to other forms of HT, 23.1% and 25.2%, respectively, stopped prescribing CEE or MPA, 63.7% decreased the dose, 55.2% opted for drugs such as bisphosphonates, tibolone and SERMS, and 46.3% began to prescribe tranquilizers, isoflavone and other natural medications. Moreover, 59.2% agreed that HT should be used for only 4-5 years. Prescriptions decreased significantly for all indications (p<0.0001).> A high percentage of gynecologists in this study knew of the WHI study and followed its recommendations concerning cardiovascular prevention; consequently they changed their management of the treatment of postmenopausal women by restricting indications for HT and decreasing its duration of use and dose.
Nenhum comentário:
Postar um comentário