RANDOMIZED TRIAL OF A PORTABLE, SELF-ADMINISTERED DECISION AID FOR POSTMENOPAUSAL WOMEN CONSIDERING LONG-TERM PREVENTIVE HORMONE-THERAPY

Although practice guidelines suggest that postmenopausal women learn a bout the benefits and risks and consider their values when deciding ab out hormone therapy, the optimal decision-support method has not been established. In a randomized controlled trial, the authors compared th e efficacy of a general educational pamphlet with that of a tailored d ecision aid. The pamphlet briefly summarized benefits, risks, and like ly beneficiaries in general terms. The decision aid, delivered via boo klet and audiotape, provided: detailed benefits and risks using functi onal terms and probabilities tailored to clinical risk; and steps for considering the issue in a woman's own situation, including a value-cl arification exercise. Compared with the pamphlet group, the decision-a id group had statistically significant (p < 0.05) improvements in term s of realistic personal expectations of the benefits and risks, decisi onal conflict, and perceived acceptability of the intervention. Levels of general knowledge about the main benefits and risks were comparabl e for the two interventions. It is concluded that tailored decision ai ds prepare women for decision making better than do general pamphlets. .