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Patient decision support intervention: increased consistency with decision analytic models.

M Holmes-Rovner1, J Kroll, D R Rovner

  • 1Michigan State University, East Lansing 48824-1317, USA. mholmes@pilot.Msu.Edu

Medical Care
|March 31, 1999
PubMed
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Patient Decision Support tools help women make informed choices about hormone replacement therapy. These tools reduce uncertainty and improve decision consistency with personal values.

Area of Science:

  • Decision science
  • Women's health
  • Medical decision-making

Background:

  • Patient Decision Support (PDS) tools aid patients in aligning medical choices with personal values.
  • PDS tools provide evidence on medical alternatives and their consequences.

Purpose of the Study:

  • To evaluate a PDS intervention for perimenopausal hormone replacement therapy (HRT).
  • Assessed PDS impact on decision consistency and likelihood to take HRT (estrogen replacement therapy/progesterone-estrogen replacement therapy).

Main Methods:

  • A randomized trial compared three PDS intervention intensities: brochure, lecture/discussion, and active decision support.
  • 248 perimenopausal women (ages 40-65) participated.
  • Decision consistency and likelihood to take HRT were measured pre- and post-intervention.

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Main Results:

  • All PDS formats reduced uncertainty, increasing certainty about HRT decisions.
  • More intensive interventions showed modest gains in decision consistency.
  • Women uncertain about estrogen replacement therapy (ERT) showed significant shifts in decisions after PDS use.

Conclusions:

  • Patient Decision Support interventions, regardless of format, effectively reduce uncertainty for informed decision-making.
  • Improved consistency with decision models stems from better outcome likelihood estimations.