Beliefs about bioidentical hormone therapy: a cross-sectional survey of pharmacists.

The aim of this study was to assess pharmacists' beliefs about bioidentical hormone therapy (BHT) and to identify factors influencing these beliefs. This was a cross-sectional survey of pharmacists. An email invitation to participate in the online survey was sent to a random sample of 2000 pharmacists in Alberta. The survey was accessible for a six-week period from May to July, 2011. A 54-item questionnaire was used to capture knowledge and beliefs about, and confidence in BHT. Summary statistics and multivariate regression were used for analyses. Overall, 401 pharmacists completed the survey (response rate 20%). Respondents were mainly female (64%), above 30 years of age (81%) and in practice for more than 10 years (63%). Only 35% of respondents correctly classified BHT as including both compounding and commercial products. In regards to beliefs, 68% of respondents agreed that BHT is as effective as non-bioidentical hormones for vasomotor symptoms, while 60% agreed BHT had equal risk. Beliefs on estriol, progesterone, and saliva testing however, were more diverse with many "do not know" responses (40%). In multivariate analysis, pharmacists who worked in pharmacies that compounded BHT were more likely to believe in BHT safety (p<0.001), and have greater confidence with BHT (p<0.001). Results from this survey indicated that pharmacists had varying beliefs on BHT. In addition, beliefs on the safety of BHT were associated with pharmacists' practice, specifically working in a pharmacy that compounds BHT. This study helps identify areas for targeted education.