title: Informed choice assistance for women making uterine fibroid treatment decisions: a practical clinical trial.
abstract: BACKGROUND
  There is limited evidence about how to ensure that patients are helped to make informed medical care decisions.
  
  
  OBJECTIVE
  To test a decision support intervention for uterine fibroid treatments.
  
  
  METHODS
  Practical clinical trial to test informed choice assistance in 4 randomly assigned gynecology clinics compared to 5 others providing a pamphlet.
  
  
  METHODS
  Three hundred women facing a treatment decision for fibroids over a 13-month period.
  
  
  METHODS
  Mailed DVD and brochure about fibroid treatments plus the Ottawa decision guide and an offer of counseling soon after an index visit.
  
  
  METHODS
  Mailed survey 6 to 8 weeks later asking about knowledge, preferences, and satisfaction with decision support.
  
  
  RESULTS
  In total, 244 surveys were completed for an adjusted response rate of 85.4%. On a 5-point scale, intervention subjects reported more treatment options being mentioned (3.0 v. 2.4), had a higher knowledge score (3.3 v. 2.8), and were more likely to report being adequately informed (4.4 v. 4.0), and their decision was both more satisfactory (4.3 v. 4.0) and more consistent with their personal values (4.5 v. 4.2). Neither knowledge nor use of the intervention was associated with greater concordance between preferences and decisions.
  
  
  CONCLUSIONS
  Implementation of intervention may not have been well timed to the decision for some patients, limiting their use of the materials and counseling.
  
  
  CONCLUSIONS
  It is difficult to integrate structured decision support consistently into practice. Decision support for benign uterine conditions showed effects on knowledge and satisfaction but not on concordance.
authors: HealthPartners, HealthPartners Medical Group, and HealthPartners Research Foundation, Minneapolis, Minnesota 55440-1524, USA. Leif.I.Solberg@healthpartners.com
authors: Leif I
authors: LI
authors: Solberg
authors: Stephen E
authors: SE
authors: Asche
authors: Karen
authors: K
authors: Sepucha
authors: N Marcus
authors: NM
authors: Thygeson
authors: Joan E
authors: JE
authors: Madden
authors: Larry
authors: L
authors: Morrissey
authors: Karen K
authors: KK
authors: Kraemer
authors: Louise H
authors: LH
authors: Anderson
mesh_terms: D002755:Choice Behavior; D003657:Decision Making; D005260:Female; D006801:Humans; D007889:Leiomyoma / Q000628:therapy*; D011795:Surveys and Questionnaires