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Impact of patient information booklet on treatment decision--a randomized trial among women with heavy menstruation
Sirkku Vuorma1, Pekka Rissanen, Anna-Mari Aalto
1STAKES, National R & D Centre for Welfare and Health, University of Tampere, Finland. sirkku.vuorma@stakes.fi
Insights
A patient information booklet increased treatment decisions for menorrhagia. Well-informed women chose treatments differently, favoring established options over newer procedures.
Area of Science:
- Gynaecology and Patient Education Research
- Reproductive Health Outcomes
Background:
- Menorrhagia significantly impacts women's quality of life.
- Patient understanding of treatment options is crucial for informed decision-making.
Purpose of the Study:
- To evaluate the influence of a patient information booklet on menorrhagia treatment decisions.
- To assess the impact of enhanced patient information on treatment modality selection and patient experience.
Main Methods:
- Conducted a randomized trial and a pre-trial prospective cohort study.
- Involved 363 (randomized) and 206 (cohort) patients with menorrhagia across 14 Finnish hospitals.
- Intervention group received a mailed information booklet on menorrhagia and treatment options prior to their clinic visit.
Main Results:
- The intervention group showed a higher rate of treatment decisions within 3 months (96% vs. 89%, P=0.02).
- Oral medication was more frequently chosen, while newer treatments (minor surgery, hormonal intrauterine system) were less utilized in the intervention group.
- Additional information did not improve patient knowledge, satisfaction, or reduce anxiety, nor did it increase surgical procedure rates.
Conclusions:
- Providing additional information increases specific treatment decisions and alters treatment distribution for menorrhagia.
- Informed patients actively participate in treatment choices, potentially influencing the adoption of newer medical interventions.
- Patient empowerment through information can lead to a more conservative approach to treatment selection.
Objective:
Does a patient information booklet influence treatment for menorrhagia?
Design:
Randomized trial and a pre-trial prospective cohort study.
Setting:
Gynaecology outpatient clinics in 14 Finnish hospitals.
Participants:
A total of 363 (randomized trial) plus 206 (cohort study) patients with menorrhagia.
Intervention:
An information booklet about menorrhagia and treatment options, mailed before the first visit to the outpatient clinic.
Main Outcome Measures:
Distribution of treatment modalities, knowledge about treatment options, satisfaction with communication with personnel and anxiety.
Results:
Treatment decision within 3 months was made more often in the intervention group than in the control group (96% and 89% respectively, P = 0.02). Oral medication was more frequently chosen, and newly introduced treatments (minor surgery, hormonal intrauterine system) were less frequently used in the intervention group (at 3-month follow-up 21% and 29%, respectively). The differences persisted at the 12-month follow-up. In the pre-trial group, new treatment methods were less frequently chosen and used than in the control group. Additional information did not increase the number of surgical procedures used, improve knowledge, or influence satisfaction or anxiety.
Conclusions:
Additional information led to an increase in specific treatment decisions and changed the distribution of used treatments without increasing the number of surgical procedures. The study suggests that well-informed women adopting an active role may counteract physicians' emphasis on newly introduced treatments.
