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Effects of decision aids for menorrhagia on treatment choices, health outcomes, and costs: a randomized controlled trial.

Andrew D M Kennedy1, Mark J Sculpher, Angela Coulter

  • 1Health Economics Research Group, Brunel University, Uxbridge, Middlesex, UB8 3PH England. andrew.kennedy@brunel.ac.uk

JAMA
|December 4, 2002

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View abstract on PubMed

Summary

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  • Biomedical And Clinical Sciences
  • Oncology And Carcinogenesis
  • Predictive And Prognostic Markers
  • Effects Of Decision Aids For Menorrhagia On Treatment Choices, Health Outcomes, And Costs: A Randomized Controlled Trial.
    • This summary is machine-generated.

    A structured interview to elicit patient preferences significantly reduced hysterectomy rates and healthcare costs for women with menorrhagia, without impacting health status.

    Area of Science:

    • Reproductive Health
    • Health Services Research
    • Decision Science

    Background:

    • Decision aids enhance patient involvement in treatment choices.
    • However, their impact on outcomes and cost-effectiveness requires further investigation.

    Purpose of the Study:

    • To evaluate the effects of informational decision aids, with and without a structured preference elicitation interview, on treatment selection, health outcomes, and costs for menorrhagia patients.

    Main Methods:

    • A randomized controlled trial involving 894 women with uncomplicated menorrhagia.
    • Participants were assigned to a control group, information-only group, or information plus preference elicitation interview group.
    • Follow-up was conducted over 2 years, assessing self-reported health status, treatments received, and healthcare costs from a UK payer perspective.

    Main Results:

    • No consistent effect on health status was observed across groups.
    • Hysterectomy rates were significantly lower in the interview group (38%) compared to the control (48%) and information-only (48%) groups.
    • The interview group incurred lower mean costs ($1566) compared to the control ($2751) and information-only ($2026) groups.

    Conclusions:

    • Information provision alone did not alter treatment choices for menorrhagia.
    • Incorporating a structured interview to elicit patient preferences significantly influenced management decisions and led to reduced healthcare costs.

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