Patient-identified needs for hormone replacement therapy counseling: A qualitative study

Background: Numerous medical organizations, including the American College of Physicians, have recommended that women be counseled about postmenopausa l hormone replacement therapy (HRT). Patients' perspectives on their counse ling needs, however, have not been integrated into most counseling guides. Objective: To use patient self-reports to identify needs for HRT counseling . Design: Individual, in-depth patient interviews. Setting: Managed care organization. Patients: 26 women who had received an initial prescription for HRT. Measurements: Qualitative, consensus review of the content of interview tra nscripts. Results: On average, women reported 15 factors (range, 6 to 24 factors) as critical to their decision-making process. Although most women cited their physician's opinion (96%), reports in the media (81%), and experiences and opinions of friends (77%) as critical to their decisions about HRT, counsel ing recommendations address none of these concerns. Conclusions: Many women in a managed care organization who accepted a presc ription for HRT identified counseling needs that are not included in widely used HRT guidelines.