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Acceptability of a substitution of estrogen replacement therapy to women enrolled in a health maintenance organization.

We evaluated the acceptability of a systematic estrogen replacement therapy (ERT) substitution program in a large U.S. health maintenance organization (HMO). Prescriptions for 14,601 enrollees were converted from Premarin tablets (PR) to Estratab tablets (ES). At the end of 6 months, 93.5% of the women continued to use ES, and 6.5% reverted to use of PR. We report the results of a telephone survey that included women randomly selected from three groups who participated in the substitution program. The groups were women whose prescriptions were converted from PR to ES (n = 253), women whose prescriptions were converted from PR to ES and back to PR (n = 250), and women who continued to use PR without converting to ES (n = 251). Two thirds of women who did not revert to use of PR were still using ES 3 years after conversion of their prescriptions. Women whose prescriptions were converted but who returned to use of PR cited both return of menopausal symptoms and development of new symptoms as reasons. Women who continued to use ES did not report return of menopausal symptoms after the conversion. Our evidence supports the conclusion that the substitution of Estratab tablets for Premarin tablets among users of ERT was well tolerated and acceptable to most affected women in this HMO setting.