Clinical Scenarios Used to Assess Intention to Prescribe Hormone Replacement Therapy

Imagine a Caucasian woman comes to you requesting advice on HRT. She does not have a preference either for or against HRT and would comply with your decision. Will you recommend HRT in the following circumstances?

Fifty-five-year-old, asymptomatic woman who lives an active life, a nonsmoker, with no significant medical conditions or significant family history of medical conditions. Sixty-five-year-old, slim woman who lives an active life, a smoker, who has a personal history of osteoporotic vertebral fracture and no other medical conditions or family history of medical conditions. Fifty-five-year-old, slim asymptomatic woman who lives an active life, a nonsmoker, who had an early menopause, with a family history of osteoporotic fracture and no other significant medical conditions. Sixty-five-year-old, obese woman who lives an inactive life, who has a personal history of coronary heart disease (myocardial infarction) and no other significant medical conditions or family history of medical conditions. Fifty-five-year-old, obese woman who lives an active life, former smoker (stopped 1 year ago), who has high serum cholesterol level, a strong family history of coronary heart disease, but no personal history of coronary events and no other significant medical conditions. Sixty-five-year-old woman who has had two osteoporotic vertebral fractures, who lives an inactive life, a smoker, who has a personal history of benign breast disease and no other significant medical conditions or family history of medical conditions. Fifty-five-year-old woman who has had two osteoporotic vertebral fractures, who lives an active life, a nonsmoker, who has a strong family history of breast cancer (sister had breast cancer at age 45) and no other significant medical conditions.