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What factors are associated with a woman's decision to take hormone replacement therapy? Evaluated in the context of a decision aid
Authors:Heather D. Clark MD CM MSc,&dagger   Annette M. O'Connor RN PhD,&dagger   Ian D. Graham PhD,&dagger  &Dagger  and George A. Wells PhD,&Dagger  
Affiliation:Department of Medicine, Ottawa Hospital, Ottawa, Ontario, Canada,;Clinical Epidemiology Unit, Ottawa Health Research Institute, Ottawa, Ontario, Canada and;Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Ontario, Canada
Abstract:Objectives To understand the factors associated with a post‐menopausal woman deciding to take hormone replacement therapy (HRT) after reviewing a decision aid (DA) and having a counselling visit with her physician as well as the factors associated with the act of taking HRT 2 months after the counselling interview. Design A secondary analysis of data collected for a randomized controlled trial evaluating two DAs. Main outcome results Although 28% of women were uncertain regarding their decision after the counselling interview, only 2.4% of women, at the assessment at 2 months, had not made a decision. The most significant factor associated with the decision to take HRT, after the physician visit, was the physician preference (OR: 62, 95% CI: 13.3, 289.7). Physician preference (OR: 78, 95% CI: 6.2, 975) remained the most significant factor for taking HRT 2 months after the counselling interview followed by low uncertainty about the decision (OR: 0.4, 95% CI: 0.2, 0.7). Conclusion Physician preference was the factor that was most associated with the woman's decision following counselling and 2 months later. Qualitative evaluation of the interview process involving the patient and physician would determine whether the patient and physician are reaching a shared decision or is the physician preference influencing the patient.
Keywords:decision-making    decision support techniques    hormone replacement therapy    menopause    women education
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