Effectiveness of a computerized decision aid in primary care on decision making and quality of life in menorrhagia: results of the MENTIP randomized controlled trial.
BACKGROUND
Computerized decision aids have the potential to increase patient involvement in the decision-making process. However, most published evidence concerning the effectiveness of decision aids is from secondary care.


OBJECTIVE
To evaluate whether the addition of a computerized decision aid to written information improves decision making in women consulting their general practitioner with menorrhagia compared with written information alone.


METHODS
of study. Randomized controlled trial.


METHODS
Nineteen general practices in the North of England.


METHODS
One hundred forty-nine women presenting with menorrhagia were randomized to receive written information and access to a computerized decision aid or written information alone. Outcomes were assessed using postal questionnaires. These were scores on the Decisional Conflict Scale and State-Trait Anxiety Inventory anxiety scale at 2 weeks and the Menorrhagia Specific Utility quality-of-life scale, knowledge about menorrhagia, and anxiety and process measures at 6 months.


RESULTS
Two weeks after the intervention, there was significantly less decisional conflict in the intervention group (adjusted difference = -16.6; 95% confidence interval [CI] = -21.5 to -11.7; P < 0.001). At 6 months, the intervention group showed better knowledge about menorrhagia (adjusted difference = 9.3 ; 95% CI = 1.9 to 16.6; P = 0.014) and menorrhagia quality of life (adjusted difference = 10.9; 95% CI = 0.9 to 21.0; P = 0.033). There was no difference in anxiety scores at either 2 weeks or 6 months.


CONCLUSIONS
A computerized decision aid, used outside of the primary care consultation, is effective in increasing patient involvement in decision making in primary care.
Protheroe
Joanne
J
National Primary Care Research and Development Centre, University of Manchester, Manchester, United Kingdom. j.protheroe@manchester.ac.uk
Bower
Peter
P
Chew-Graham
Carolyn
C
Peters
Tim J
TJ
Fahey
Tom
T
D000328:Adult; D001331:Automation; D003299:Cooperative Behavior; D020000:Decision Support Systems, Clinical; D004739:England; D005260:Female; D006801:Humans; D008595:Menorrhagia; D008875:Middle Aged; D010353:Patient Education as Topic; D010358:Patient Participation; D011788:Quality of Life; D014584:User-Computer Interface