Using a Shared Decision Making Tool to Clarify Patient Preference for Treatment Options of Menopausal Symptoms [21M

Abstract

INTRODUCTION: Decision counselling may prepare women for shared decision making about menopausal symptom treatment. METHODS: Women reporting menopausal vasomotor symptoms or genitourinary syndrome of menopause (GSM) were referred and consented. A nurse educator led a decision counselling session comprising review of an educational brochure and an online tool to clarify treatment preferences. Treatment options included non-hormone treatment vs. systemic hormones for vasomotor symptoms and non-hormone treatment vs. topical hormone treatment for GSM. Patients and their providers received a preference summary. Frequency of preferred treatments were calculated. An endpoint survey assessed participant perception of their preparation to discuss treatment options with their providers. RESULTS: A total 36 women with GSM (N=18) or vasomotor symptoms without a contraindication to systemic hormone therapy (N=18) completed a decision counseling session. Of these, 25 completed the endpoint survey. Among women with vasomotor symptoms, 6 (33%) preferred non-hormone treatment, 7 (39%) preferred hormone treatment, and 5 (28%) had an equal preference for these options. Among women with GSM, 6 (33%) preferred non-hormone treatment, 7 (39%) preferred topical hormone therapy, and 5 (28%) had an equal preference for these options. Ninety-six percent (24/25) felt the decision counseling session helped prepare them to discuss treatment options with their provider. CONCLUSION: After a decision counselling session, 72% percent of women with menopausal symptoms expressed a clear preference for a particular treatment and 96% felt more prepared to discuss treatment options with their provider. Decision counselling may add value to care of menopausal women. Further research should evaluate impact on the subsequent office visit.