Decision-making at menopause: a randomized controlled trial of a computer-based hormone therapy decision-aid.
OBJECTIVE
Decision-making at menopause remains a challenge for women and their health care providers as the paradigm for hormone therapy continues to evolve. The role of decision-support for this process remains to be defined.


METHODS
A randomized controlled trial of a computer-based hormone therapy (HT) decision-aid versus a control intervention consisting of a printed pamphlet among 177 post-menopausal women receiving care in a Veterans Affairs Medical Center.


RESULTS
Participants found the computer-based decision-aid easy to use and retained risk information incorporated from emerging scientific data. There was no difference between groups with respect to the primary outcomes of knowledge, satisfaction with decision, decisional conflict or HT use. A trend was reported towards decreased decisional conflict in the evidence in decision-making (p=0.07) and factors of uncertainty (p=0.06) domains among the subset of participants who were on HT at baseline and used the computer-based decision-aid.


CONCLUSIONS
The computer-based decision-aid was able to effectively incorporate emerging scientific information but was no more effective than a printed pamphlet control with regard to improving decision-process outcomes.


CONCLUSIONS
The incremental benefit of a complex versus simpler decision-aid for post-menopausal women remains to be established prior to widespread dissemination of interactive computer-based HT decision-aids.
Schapira
Marilyn M
MM
The Clement J. Zablocki VA Medical Center, The Division of General Internal Medicine, Medical College of Wisconsin, Wisconsin, USA. mschap@mcw.edu
Gilligan
Mary Ann
MA
McAuliffe
Timothy
T
Garmon
Gwenn
G
Carnes
Molly
M
Nattinger
Ann B
AB
D003658:Decision Making, Computer-Assisted; D015914:Estrogen Replacement Therapy; D005260:Female; D006801:Humans; D016015:Logistic Models; D008593:Menopause; D008875:Middle Aged; D017060:Patient Satisfaction; D018570:Risk Assessment; D014481:United States