Factors associated with the difference in score between women's and doctors' decisional conflict about hormone therapy: a multilevel regression analysis.
OBJECTIVE
To explore factors associated with the difference in score between women's and doctors' decisional conflict about hormone therapy (HT).


METHODS
Secondary analysis.


METHODS
family doctors were randomized to prepare women for counselling about HT using either a decision aid or a pamphlet.


METHODS
After each counselling session, decisional conflict was assessed in women and doctors using the Decisional Conflict Scale (DCS) and the Provider Decision Process Assessment Instrument (PDPAI), respectively. The difference in score between the DCS and PDPAI was computed and entered as the dependent variable in a multilevel regression analysis.


RESULTS
A total of 40 doctors and 167 women were included in the analysis. The intra-doctor correlation coefficient was 0.25. Factors associated with women experiencing higher decisional conflict than their doctor were: age of doctor >45 years, women who were undecided about the best choice after the counselling session, women with a university degree and women who said that their doctor usually does not give them control over treatment decision. Factors associated with doctors experiencing more decisional conflict than women were: doctors who were undecided about the quality of the decision, length of visit <30 min and women who thought that the decision was shared with their doctor.


CONCLUSIONS
In order to reduce the disparities between women's and doctors' decisional conflict about HT, interventions aimed at raising awareness of doctors about shared decision-making should be encouraged.
Légaré
France
F
Université Laval, Québec, Canada. france.legare@mfa.ulaval.ca
Tremblay
Stéphane
S
O'Connor
Annette M
AM
Graham
Ian D
ID
Wells
Georges A
GA
Jacobsen
Mary Jane
MJ
D002170:Canada; D003376:Counseling; D003657:Decision Making; D034462:Dissent and Disputes; D015914:Estrogen Replacement Therapy; D005194:Family Practice; D005260:Female; D006302:Health Services Research; D006801:Humans; D008875:Middle Aged; D010358:Patient Participation; D010817:Physician-Patient Relations; D012044:Regression Analysis