Skip to main content Skip to navigation

Socioeconomic status and HRT prescribing: a study of practice-level data in England

Background Concerns have been raised that women from deprived backgrounds are less likely to be receiving hormone replacement therapy (HRT) treatment and its benefits, although evidence in support of this is lacking.

Aim To investigate general practice HRT prescription trends and their association with markers of socioeconomic deprivation.

Design and setting Cross-sectional study of primary care prescribing data in England in 2018.

Method Practice-level prescribing rate was defined as the number of items of HRT prescribed per 1000 registered female patients aged ≥40 years. The association between Index of Multiple Deprivation (IMD) score and HRT prescribing rate was tested using multivariate Poisson regression, adjusting for practice proportions of obesity, smoking, hypertension, diabetes, coronary heart disease and cerebrovascular disease, and practice list size.

Key findings:

The overall prescribing rate of HRT was 29% lower in practices from the most deprived quintile compared with the most affluent.

After adjusting for all cardiovascular disease outcomes and risk factors, the prescribing rate in the most deprived quintile was still 18% lower than in the least deprived quintile

In more deprived practices, there was a significantly higher tendency to prescribe oral HRT than transdermal preparations (P<0.001).

Research team members:

Sarah Hillman, Saran Shantikumar, Ali Ridha, Dan Todkill and Jeremy Dale 


Jan 2018-Dec 2018


Dr Sarah Hillman

s dot hillman at warwick dot ac dot uk