Patient Decision Support Intervention

Increased Consistency With Decision Analytic Models

Datos Bibliográficos

ID9104427
AutoresMargaret Holmes-Rovner, Margaret Holmes‐Rovner (0000-0002-8725-7938, Fund for Scientific Research), Jill Kroll (Fund for Scientific Research), David R Rovner (Fund for Scientific Research), Neal Schmitt (0000-0002-2806-348X, Fund for Scientific Research), Marilyn L Rothert (Fund for Scientific Research), Marilyn Rothert, Georgia Padonu (Fund for Scientific Research), Geraldine Talarczyk (Fund for Scientific Research)
Año1999
Volumen37
Número3
Páginas270-284
Fecha de publicación1999-03-01
Peer ReviewedSí
Open AccessNo
TipoARTICLE
RevistaMedical Care (JOURNAL)
Identificadores de la revistaISSN: 0025-7079 • E-ISSN: 1537-1948
EditorialOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/00005650-199903000-00007
PMID10098571
OpenAlexW1997679514
IdiomaEN
Citas recibidas7
Referencias citadas26

BACKGROUND: Patient Decision Support (PDS) tools assist patients in using medical evidence to make choices consistent that are with their values and in using evidence about consequences of medical alternatives. OBJECTIVE: To evaluate a PDS intervention for perimenopausal hormone replacement therapy. We assessed the impact of the PDS on (1) consistency between the decision to take estrogen replacement therapy (ERT) or progesterone/estrogen replacement therapy (PERT) and the expected utility of treatment and (2) likelihood to take ERT and PERT pre- and postintervention. DESIGN: Content of the PDS was standardized. Randomized trial of three intensities of intervention: (1) brochure; (2) lecture/discussion; and (3) active decision support. SUBJECTS: Participants were perimenopausal community volunteers between the ages of 40 and 65 (n = 248). MEASURES: (1) Consistent with values (correlation between expected utility (EU) and likelihood of taking hormones); and (2) Likelihood to take hormone replacement therapy. RESULTS: (1) The brochure group was less consistent with the decision analytic model than the lecture/discussion and active decision support groups. (2) Influence on decisions: PDS tools increased the number of women certain about whether or not to take hormones. There were no differences among experimental groups. Of 99 women uncertain about ERT pre-PDS, 65% changed. Twenty-one (32%) decided against ERT and 44 (68%) decided for ERT. (3) More intensive interventions produced modest gains in a normative direction. CONCLUSIONS: PDSs using any of 3 formats reduce uncertainty and assist women to make informed decisions. Increased consistency with decision analytic models appears to be driven by better estimates of likelihood of outcomes

Alternative medicine · Consistency (knowledge bases) · Data mining · Decision aids · Decision analysis · Decision model · Decision support system · Estrogen · Estrogen replacement therapy · Hormone replacement therapy (female-to-male) · Intervention (counseling) · Normative · Physical therapy · Psychological intervention · Randomized controlled trial · Statistics · BRCA gene mutations in cancer · Computer Science · Internal Medicine · Medicine · Menopause: Health Impacts and Treatments · Nursing · Patient-Provider Communication in Healthcare · Psychology