IMPACT OF PHARMACIST CONSULTATION VERSUS A DECISION AID ON DECISION-MAKING REGARDING HORMONE REPLACEMENT THERAPY
Date
2002
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ORCID
Type
Degree Level
Masters
Abstract
Hormone replacement therapy (HRT) is the gold standard for managing menopausal symptoms and is recommended for prevention of diseases associated with menopause. However, at least half of women with an indication for HRT do not receive therapy and few persist long enough to achieve its protective benefits.
The study's main objective was to compare two educational methods designed to increase women's understanding of HRT and their satisfaction with the subsequent decision-making process.
The study design was a prospective, randomized comparative trial. Peri- and post-menopausal female patients aged 48 to 52 of a Saskatoon family medicine clinic (N=994) were invited to participate. Volunteers (n=128) received either a private consultation with a pharmacist or a take-home decision aid. Surveys were completed prior to the intervention and following a physician appointment to discuss HRT. Outcome measures included: perception of being informed about HRT, decisional conflict, satisfaction with the education, the decision made regarding HRT, and adherence to HRT if prescribed. Telephone follow-up occurred three months after the physician appointment.
Of the 87 women completing the trial, 38.5 percent chose HRT, 16.4 percent declined and 45.1 percent opted to delay their decision. Both interventions significantly increased perceptions of being informed and decreased decisional conflict. Satisfaction with the education and with the HRT decision was high. There were no significant differences between the groups.
Adherence was high, with none of those initiating HRT during the study discontinuing it at three months. Only 6.1 percent reported missing doses occasionally and another 21.2 percent self-adjusted their regimen. Follow-up is planned at 12 months to provide more definitive data about the relationship between study variables and adherence.
Both interventions were successful in aiding peri- and post-menopausal women to become more informed about HRT and reducing the amount of decisional conflict surrounding this difficult medical decision.
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Degree
Master of Science (M.Sc.)
Department
Pharmacy and Nutrition